Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis
Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis
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DOI：
10.1007/s00330-008-1194-4
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发表时间：
2009-03-01
影响因子：
5.9
通讯作者：
Kwee, Robert M.
中科院分区：
文献类型：
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作者：
Kwee, Thomas C.;Kwee, Robert M.
本研究的目的是系统回顾和荟萃分析已发表的关于 18F-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描 (FDG-PET/CT) 联合检测原发性未知癌症 (CUP) 患者原发性肿瘤的诊断性能的数据。对 PubMed/MEDLINE 和 Embase 数据库进行了相关研究的系统检索。对纳入研究的方法学质量进行了评估。对报告的检出率、敏感性和特异性进行了荟萃分析。如果个别研究的结果存在异质性，则进行亚组分析。这 11 项纳入研究的总样本量为 433 名 CUP 患者，方法学质量中等。 FDG-PET/CT 的总体原发肿瘤检出率、汇总敏感性和特异性分别为 37%、84% (95% CI 78-88%) 和 84% (95% CI 78-89%)。各个研究的敏感性存在异质性 (P = 0.0001)，而各个研究的特异性则具有同质性 (P = 0.2114)。 FDG-PET/CT 前诊断检查的完整性、原发灶不明的转移灶位置、CT 造影剂的使用、评估的 FDG-PET/CT 图像类型以及 FDG-PET/CT 复查方式均不会显着影响诊断性能。总之，FDG-PET/CT 可以成为未知原发肿瘤检测的有用方法。未来的研究需要证明 FDG-PET/CT 相对于单独 FDG-PET 的假定优势，并进一步探讨异质性的原因。
The aim of this study was to systematically review and meta-analyze published data on the diagnostic performance of combined 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of primary tumors in patients with cancer of unknown primary (CUP). A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Methodological quality of the included studies was assessed. Reported detection rates, sensitivities and specificities were meta-analyzed. Subgroup analyses were performed if results of individual studies were heterogeneous. The 11 included studies, comprising a total sample size of 433 patients with CUP, had moderate methodological quality. Overall primary tumor detection rate, pooled sensitivity and specificity of FDG-PET/CT were 37%, 84% (95% CI 78-88%) and 84% (95% CI 78-89%), respectively. Sensitivity was heterogeneous across studies (P = 0.0001), whereas specificity was homogeneous across studies (P = 0.2114). Completeness of diagnostic workup before FDG-PET/CT, location of metastases of unknown primary, administration of CT contrast agents, type of FDG-PET/CT images evaluated and way of FDG-PET/CT review did not significantly influence diagnostic performance. In conclusion, FDG-PET/CT can be a useful method for unknown primary tumor detection. Future studies are required to prove the assumed advantage of FDG-PET/CT over FDG-PET alone and to further explore causes of heterogeneity.