Diagnostic value of [18F]FDG-PET/CT for treatment monitoring in large vessel vasculitis: a systematic review and meta-analysis.
Diagnostic value of [18F]FDG-PET/CT for treatment monitoring in large vessel vasculitis: a systematic review and meta-analysis.
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DOI：
10.1007/s00259-021-05362-8
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发表时间：
2021-11
影响因子：
9.1
通讯作者：
Slart RHJA
中科院分区：
文献类型：
--
作者：
van der Geest KSM;Treglia G;Glaudemans AWJM;Brouwer E;Sandovici M;Jamar F;Gheysens O;Slart RHJA
监测大血管炎（LVV）患者的疾病活动可能具有挑战性。[18F]FDG-PET/CT越来越多地用于评价LVV的治疗反应。在本系统综述和荟萃分析中，我们旨在总结[18 F]FDG-PET/CT用于LVV治疗监测价值的现有证据。检索了PubMed/MEDLINE和科克伦图书馆数据库，检索时间从开始到2020年10月21日。纳入了包含接受治疗并接受[18 F]FDG-PET/CT的LVV（即巨细胞动脉炎、大动脉炎和孤立性动脉炎）患者的研究。由2名研究者进行筛选、全文审查和数据提取。使用QUADAS-2工具检查偏倚风险。分别采用随机效应模型和双变量模型对比例和诊断试验准确性进行荟萃分析。21项研究被纳入系统综述，其中8项研究符合荟萃分析的条件。在纵向研究中，临床缓解后动脉[18F]FDG摄取减少。高异质性（I2统计94%）排除了临床缓解期间扫描正常化的患者比例的荟萃分析。横断面研究的荟萃分析表明，[18 F]FDG-PET/CT可检测复发/难治性疾病，敏感性为77%（95%CI 57-90%），特异性为71%（95%CI 47-87%）。在横断面研究中观察到了显著的异质性。临床方面和成像程序的差异均导致异质性。LVV治疗导致临床缓解期间动脉[18F]FDG摄取减少。[18F]FDG-PET/CT检测活动性LVV的诊断准确性中等。[18F]FDG-PET/CT可能有助于LVV的治疗监测，但其结果应在临床怀疑疾病活动的背景下进行解释。本研究强调了已发表的关于在LVV中使用[18 F]FDG-PET/CT的手术建议的相关性。在线版本包含补充材料，可通过10.1007/s 00259 -021-05362-8获得。
Monitoring disease activity in patients with large vessel vasculitis (LVV) can be challenging. [18F]FDG-PET/CT is increasingly used to evaluate treatment response in LVV. In this systematic review and meta-analysis, we aimed to summarize the current evidence on the value of [18F]FDG-PET/CT for treatment monitoring in LVV. PubMed/MEDLINE and the Cochrane library database were searched from inception through October 21, 2020. Studies containing patients with LVV (i.e. giant cell arteritis, Takayasu arteritis and isolated aortitis) that received treatment and underwent [18F]FDG-PET/CT were included. Screening, full-text review and data extraction were performed by 2 investigators. The risk of bias was examined with the QUADAS-2 tool. Meta-analysis of proportions and diagnostic test accuracy was performed by a random-effects model and bivariate model, respectively. Twenty-one studies were included in the systematic review, of which 8 studies were eligible for meta-analysis. Arterial [18F]FDG uptake decreased upon clinical remission in longitudinal studies. High heterogeneity (I2 statistic 94%) precluded meta-analysis of the proportion of patients in which the scan normalized during clinical remission. Meta-analysis of cross-sectional studies indicated that [18F]FDG-PET/CT may detect relapsing/refractory disease with a sensitivity of 77% (95%CI 57–90%) and specificity of 71% (95%CI 47–87%). Substantial heterogeneity was observed among the cross-sectional studies. Both variation in clinical aspects and imaging procedures contributed to the heterogeneity. Treatment of LVV leads to reduction of arterial [18F]FDG uptake during clinical remission. [18F]FDG-PET/CT has moderate diagnostic accuracy for detecting active LVV. [18F]FDG-PET/CT may aid treatment monitoring in LVV, but its findings should be interpreted in the context of the clinical suspicion of disease activity. This study underlines the relevance of published procedural recommendations for the use of [18F]FDG-PET/CT in LVV. The online version contains supplementary material available at 10.1007/s00259-021-05362-8.
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影响因子：
2.7
作者：
Koster, Matthew J.;Warrington, Kenneth J.
通讯作者：
Warrington, Kenneth J.
影响因子：
7.2
作者：
Deeks, JJ;Macaskill, P;Irwig, L
通讯作者：
Irwig, L
影响因子：
5.5
作者：
Mackie, Sarah L.;Dejaco, Christian;Dasgupta, Bhaskar
通讯作者：
Dasgupta, Bhaskar
影响因子：
13.3
作者：
Grayson, Peter C.;Alehashemi, Sara;Ahlman, Mark A.
通讯作者：
Ahlman, Mark A.
DOI：
10.1007/s00259-017-3639-y
发表时间：
2017-07-01
影响因子：
9.1
作者：
Incerti, Elena;Tombetti, Enrico;Picchio, Maria
通讯作者：
Picchio, Maria