18F-FDOPA与18F-FDG PET/CT诊断脑肿瘤的系统评价

目的 系统评价18F-FDOPA与18F-FDG PET/CT显像在脑肿瘤诊断中的临床价值.方法 采用Meta分析与直接比较方法.使用计算机检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library,从建库至2016年10月,搜索直接比较18F-FDOPA与18F-FDG PET/CT诊断脑肿瘤的诊断性试验.用Meta-Disc 1.4软件进行分析,计算两种不同显像剂的合并敏感度(sensitivity,SEN)、合并特异度(specificity,SPE)、合并阳性似然比(positive likelihood ratio,+LR)、合并阴性似然比(negative likelihood ratio,-LR)、诊断优势比(diagnostic odds ratio,DOR),并绘制综合受试者工作特征曲线计算曲线下面积(area under curve,AUC)与Q*值.结果 最终共纳入4篇文章,Meta 分析结果显示,18F-FDOPA PET/CT对脑肿瘤诊断的合并SEN为0.97(95％ CI =0.90 ～ 1.00),SPE为0.67(95％ CI =0.45 ～0.84),+LR为2.31 (95％ CI=1.40 ～3.81),-LR为0.07 (95％ CI =0.02～ 0.24),DOR为39.72(95％ CI=8.94～176.48),AUC为0.9725,Q*为0.9239.18F-FDG PET/CT对脑肿瘤诊断的合并SEN为0.51(95％CI=0.39～0.63),SPE为0.75(95％ CI=0.53 ～0.90,+LR为l.59(95％ CI=0.70 ～ 3.61),-LR为0.63(95％ CI =0.47 ～0.86),DOR为2.55(95％ CI =0.82 ～7.92),AUC为0.5848,Q*为0.5638.结论 18F-FDOPA PET/CT显像诊断脑肿瘤的敏感性比18F-FDG高,对脑肿瘤具有良好的诊断价值,可作为脑肿瘤诊断的方法之一.

A systematic comparison of 18F-FDOPA PET/CT with 18F-FDG PET/CT for diagnosis of brain tumors

Objective To compare the diagnostic value of 18 F-FDOPA and 18 F-FDG PET/CT scan in patients with brain tumors by Meta analysis.Methods Data on diagnostic experiments related to the diagnostic value of ~ F-FDOPA and 18 F-FDG PET/CT scan for brain tumors was retrieved from CNKI,CSJD,WanFang Database,CBM,PubMed,Embase,Cochrane Library by October 2016.The diagnostic value of 18 F-FDOPA and 18F-FDG PET/CT scan for brain tumors was compared.Meta-DiSc 1.4 software was used to analyze the pooled sensitivity (SEN),specificity (SPE),positive likelihood ratio (+ LR),negative likelihood ratio (-LR),diagnostic odds ratio (DOR) under curve (AUC) the two different imaging agents.Results A total of four studies met the inclusion criteria.According to the results of 18F-FDOPA in diagnosis of brain tumors,the pooled SEN was 0.97(95％ CI =0.90-1.00),SPE 0.67(95％ CI =0.45-0.84),2.31(95％CI=1.40-3.81),0.07(95％CI=0.02-0.24),DOR 39.72(95％CI =8.94-176.48),SROC AUC 0.9725,and Q * value.According to the diagnostic results of 18F-FD,the pooled SEN was 0.51 (95％ CI =0.39-0.63),0.75 (95％ CI =0.53-0.90),2.31 (95％ CI =0.70-3.61),0.07(95％ CI =0.47-0.86),DOR 2.55(95％ CI =0.82-7.92),SROC AUC 0.5848,and Q* value was 0.5638.Conclusions 18F-FDOPA PET/CT imaging is more sensitive than 18F-FDG in the diagnosis of brain tumors.18F-FDO-PA is of high diagnostic value for brain tumors and can be used as a reliable diagnostic method of brain tumors.