Performance of 18F-FET versus 18F-FDG-PET for the diagnosis and grading of brain tumors: systematic review and meta-analysis
Performance of 18F-FET versus 18F-FDG-PET for the diagnosis and grading of brain tumors: systematic review and meta-analysis
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DOI：
10.1093/neuonc/nov148
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发表时间：
2016-03-01
期刊：
影响因子：
15.9
通讯作者：
Prior, John O.
中科院分区：
文献类型：
--
作者：
Dunet, Vincent;Pomoni, Anastasia;Prior, John O.
在过去的十年中，F-18-氟-乙基-L-酪氨酸（FET）和F-18-氟-脱氧-葡萄糖（FDG）正电子发射断层扫描（PET）已被用于脑肿瘤患者的评估。然而，直接比较研究仅报告了有限数量的患者。我们的目的是比较FET和FDG-PET的诊断性能。我们检查了PubMed数据库中1995年1月至2015年1月期间发表的研究。要纳入该研究，应：（i）使用FET和FDG-PET评估孤立性脑病变患者，（ii）使用组织学作为金标准。在每例患者的基础上进行分析。采用STARD和QUADAS标准评价研究质量，共纳入5项研究（119例患者）。对于脑肿瘤的诊断，FET-PET的综合灵敏度为0.94（95% CI：0.79-0.98），合并特异性为0.88（95% CI：0.37-0.99），曲线下面积为0.96（95% CI：0.94-0.97），阳性似然比（LR+）为8.1（95% CI：0.8-80.6），阴性似然比（LR-）为0.07（95% CI：0.02-0.30），而FDG-PET显示灵敏度为0.38（95% CI：0.27-0.50），特异性为0.86（95% CI：0.31-0.99），曲线下面积为0.40（95% CI：0.36-0.44），LR+为2.7（95% CI：0.3-27.8），LR-为0.72（95% CI：0.47-1.11）。然而，FDG或FET的靶-本底比可以区分低级别和高级别胶质瘤（P > 0.11）。对于脑肿瘤诊断，FET-PET的表现要优于FDG，在评估新的孤立脑肿瘤时应首选。然而，对于神经胶质瘤分级，两种示踪剂表现出相似的性能。
For the past decade F-18-fluoro-ethyl-l-tyrosine (FET) and F-18-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) have been used for the assessment of patients with brain tumor. However, direct comparison studies reported only limited numbers of patients. Our purpose was to compare the diagnostic performance of FET and FDG-PET.We examined studies published between January 1995 and January 2015 in the PubMed database. To be included the study should: (i) use FET and FDG-PET for the assessment of patients with isolated brain lesion and (ii) use histology as the gold standard. Analysis was performed on a per patient basis. Study quality was assessed with STARD and QUADAS criteria.Five studies (119 patients) were included. For the diagnosis of brain tumor, FET-PET demonstrated a pooled sensitivity of 0.94 (95% CI: 0.79-0.98) and pooled specificity of 0.88 (95% CI: 0.37-0.99), with an area under the curve of 0.96 (95% CI: 0.94-0.97), a positive likelihood ratio (LR+) of 8.1 (95% CI: 0.8-80.6), and a negative likelihood ratio (LR-) of 0.07 (95% CI: 0.02-0.30), while FDG-PET demonstrated a sensitivity of 0.38 (95% CI: 0.27-0.50) and specificity of 0.86 (95% CI: 0.31-0.99), with an area under the curve of 0.40 (95% CI: 0.36-0.44), an LR+ of 2.7 (95% CI: 0.3-27.8), and an LR- of 0.72 (95% CI: 0.47-1.11). Target-to-background ratios of either FDG or FET, however, allow distinction between low- and high-grade gliomas (P > .11).For brain tumor diagnosis, FET-PET performed much better than FDG and should be preferred when assessing a new isolated brain tumor. For glioma grading, however, both tracers showed similar performances.