摘要
目的：探讨用Meta分析方法评价18F-FDG PET、CT及PET/CT对肝脏恶性肿瘤射频消融术后残余瘤的诊断价值。方法：电子检索PubMed、EBSCO、Springer、Ovid和CNKI以及Cochrane图书馆数据库，文献检索起止时间均从建库至2010年4月，同时检索纳入文献的参考文献。纳入有关评价18F-FDG PET、CT及PET/CT对肝脏恶性肿瘤射频消融术后残余瘤诊断价值的文献，并逐个进行质量评价和资料提取。采用MetaDiSc1.4软件对数据进行分析，并探讨影响诊断效能的因素。结果：符合纳入标准的文献共12篇，各研究之间存在异质性，按照随机效应模型计算，CT汇总特异度最高为0.93（95%CI：0.91~0.95）；PET/CT汇总敏感度最高为0.90（95%CI：0.86~0.94）。18F-FDG PET、CT及PET/CT汇总诊断比值比分别为0.9037、0.7372及0.9142。PET和PET/CT在敏感度、特异度及诊断比值比上均无统计学差异。而CT由于受病灶周围炎症反应的影响而诊断准确率降低。另外肿瘤的组织学类型及术后复查时间影响PET及PET/CT的诊断价值。结论：PET与PET/CT对肝脏恶性肿瘤射频消融术后残余瘤诊断准确率优于CT，对于肝转移癌优势更加显著，术后早期复查是提高诊断准确率的有效手段。
Abstract
Objective: To perform a Meta-analysis comparing current noninvasive imaging methods[18F fluorodeoxyglucose(FDG) positron emission tomography(PET), PET/CT, and CT] in the detection of residual tumor after radiofrequency ablation of hepatic malignancies. Materials and Methods: MEDLINE, EMBASE, Cochrane library and some other databases, from January 1966 to April 2010, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of 18F-FDG PET, PET/CT, and CT for patients with residual tumor after radiofrequency ablation of hepatic malignancies were collected. Methodological quality was assessed. The statistic software called “Meta-Disc 1.4” was used for data analysis. A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity. Results: In 12 included studies, CT had the highest pooled specificity, 0.93(95%CI: 0.91~0.95); PET/CT had highest pooled sensitivity, 0.90(95%CI: 0.86~0.94). The AUC of PET, PET/CT and CT were 0.9037, 0.7372 and 0.9142 respectively. The pooled sensitivity, pooled specificity and AUC showed no statistical significance between PET alone and PET/CT. For CT, its diagnostic value decreased in differentiating residual tumor for patients with inflammatory reaction around the lesion. The pathological types of liver tumors also affect the diagnostic value of PET and PET/CT. There was heterogeneity among studies and evidence of publication bias. Conclusion: 18F-FDG PET and PET/CT can provide added diagnostic information compared with CT in patients after radiofrequency ablation of hepatic malignancies. FDG-PET/CT is a more sensitive method in the follow-up of hepatic malignancies after radiofrequency ablation, particularly in patients with liver metastases.
关键词
肝肿瘤 /
导管消融术 /
Meta分析 /
氟脱氧葡萄糖F18 /
正电子发射断层显像术
Key words
Liver neoplasms /
Catheter ablation /
Meta-analysis /
Fluorodeoxyglucose F18 /
Positron-emission tomography
畅智慧;刘兆玉;郑加贺;单 明;卢再鸣;郭启勇.
18F-FDG PET、CT及PET/CT对肝脏恶性肿瘤射频消融术后残余瘤诊断的Meta分析[J]. 中国临床医学影像杂志. 2010, 21(11): 774-777
CHANG Zhi-hui;LIU Zhao-yu;ZHENG Jia-he;SHAN Ming;LU Zai-ming;GUO Qi-yong.
Detecting of residual tumor after radiofrequency ablation of hepatic malignancies byusing 18F-FDG PET, PET/CT and CT: a Meta-analysis[J]. Journal of China Clinic Medical Imaging. 2010, 21(11): 774-777
中图分类号：
Ｒ735.7
Ｒ814.42
Ｒ817.4
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