肝细胞癌TACE术后病灶存活或复发18F-FDGPET/CT和增强CT诊断价值Meta分析

目的采用Meta分析方法评价¹⁸F-脱氧葡萄糖正电子发射计算机体层摄影(¹⁸F-FDG PET/CT)和增强CT(CECT)诊断经导管肝动脉化疗栓塞术(TACE)术后存活或复发病灶的临床价值。方法根据PRISMA报告规范开展Meta分析。检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方和维普数据库中¹⁸F-FDG PET/CT和CECT诊断TACE术后存活或复发病灶的临床研究,时间至2019-04。由2位研究人员独立筛选文献、提取资料,根据诊断准确性研究质量评价工具-2(QUADAS-2)评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析,计算其汇总敏感度(Sen)和特异度(Spe),绘制受试者工作特征曲线(SROC)并计算曲线下面积(AUC)。结果共纳入10篇¹⁸F-FDG PET/CT及13篇CECT诊断TACE术后存活或复发病灶的原始研究,分别包括322例患者的467个病灶和748例患者的943个病灶。Meta分析显示,¹⁸F-FDG PET/CT诊断TACE术后存活或复发病灶的Sen=0.92(95%CI为0.87~0.94)、Spe=0.95(95%CI为0.82~0.99)、AUC=0.97(95%CI为0.93~0.99);CECT诊断TACE术后存活或复发病灶的Sen=0.72(95%CI为0.66~0.78)、Spe=0.99(95%CI为0.93~1.00)、AUC=0.87(95%CI为0.83~0.89)。此外,CECT诊断TACE术后存活或复发Sen(Z=2.34,P=0.02)和AUC(Z=2.21,P=0.03)值低于¹⁸F-FDG PET/CT,差异有统计学意义。结论相比于CECT,¹⁸F-FDG PET/CT对TACE术后存活或复发病灶具有较高诊断效能,可视为TACE术后存活或复发病灶有效的影像学诊断方法。

Value of 18F-FDG PET/CT and contrast enhnced CT in diagnosing residual or recurrent leision after TACE:A Meta-analysis

Objective To evaluate the clinical value of ¹⁸F-FDG PET/CT and contrast enhanced computed tomography(CECT)in diagnosing residual or recurrent leision after TACE.Methods This meta analysis was conducted accoding to PRISMA guideline.The articles concerning the diagnosis of residual or recurrent leision after TACE by using ¹⁸F-FDG PET/CT and/or CECT were systematically searched in databases including PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang and VIP data.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies by using the QUADAS-2 tool.Then,this meta-analysis was performed by using Stata 12.0 software.The pooled weighted sensitivity and specificity were calculated,the summary receiver operating characteristic curve(SROC)was drawn and the area under the curve(AUC)was also calculated.Results Ten studies with 322 patients and 467 leisions on ¹⁸F-FDG PET/CT,thirteen studies with 748 patients and 943 leisions on CECT were finally included in our meta-analysis.Results of this research showed pooled Sen,Spe and AUC of ¹⁸F-FDG PET/CT in diagnosing residual or recurrent leision after TACE were 0.92(95%CI:0.87-0.94),0.95(95%CI:0.82-0.99),0.97(95%CI:0.93-0.99),respectively,and they were 0.72(95%CI:0.66-0.78),Spe=0.99(95%CI:0.93-1.00),AUC=0.87(95%CI:0.83-0.89)for CECT.In addition,the Sen and AUC value of CECT in diagnosing residual or recurrent leision after TACE were lower compared with ¹⁸F-FDG PET/CT(Sen:Z=2.34,P=0.02;AUC:Z=2.21,P=0.03).Conclusion In comparasion with CECT,¹⁸F-FDG PET/CT had excellent diagnostic value and may served as a noninvalsive imaging in diagnosing residual or recurrent leision after TACE.