Abstract:
Due to the importance of correct and timely diagnosis of bone metastases in advanced breast cancer (BrC), we performed a meta-analysis evaluating the diagnostic accuracy of [18F]FDG, or Na[18F]F PET, PET(/CT), and (/MRI) versus [99mTc]Tc-diphosphonates bone scintigraphy (BS). The PubMed, Embase, Scopus, and Scholar electronic databases were searched. The results of the selected studies were analyzed using pooled sensitivity and specificity, diagnostic odds ratio (DOR), positive-negative likelihood ratio (LR+-LR-), and summary receiver-operating characteristic (SROC) curves. Eleven studies including 753 BrC patients were included in the meta-analysis. The patient-based pooled values of sensitivity, specificity, and area under the SROC curve (AUC) for BS (with 95% confidence interval values) were 90% (86-93), 91% (87-94), and 0.93, respectively. These indices for [18F]FDG PET(/CT) were 92% (88-95), 99% (96-100), and 0.99, respectively, and for Na[18F]F PET(/CT) were 96% (90-99), 81% (72-88), and 0.99, respectively. BS has good diagnostic performance in detecting BrC bone metastases. However, due to the higher and balanced sensitivity and specificity of [18F]FDG PET(/CT) compared to BS and Na[18F]F PET(/CT), and its advantage in evaluating extra-skeletal lesions, [18F]FDG PET(/CT) should be the preferred multimodal imaging method for evaluating bone metastases of BrC, if available.
摘要:
由于正确及时诊断晚期乳腺癌(BrC)骨转移的重要性,我们进行了荟萃分析,评估[18F]FDG的诊断准确性,或Na[18F]FPET,PET(/CT),和(/MRI)与[99mTc]Tc-二膦酸盐骨闪烁显像(BS)。PubMed,Embase,Scopus,搜索了学者的电子数据库。所选研究的结果使用汇总的敏感性和特异性进行分析,诊断优势比(DOR),正负似然比(LR+-LR-),和汇总接受者工作特性(SROC)曲线。11项研究包括753例BrC患者纳入荟萃分析。基于患者的汇总敏感度值,特异性,BS的SROC曲线下面积(AUC)(具有95%置信区间值)为90%(86-93),91%(87-94),和0.93。[18F]FDGPET(/CT)的这些指标为92%(88-95),99%(96-100),和0.99,分别对于Na[18F]FPET(/CT)为96%(90-99),81%(72-88),和0.99。BS在检测BrC骨转移方面具有良好的诊断性能。然而,由于与BS和Na[18F]FPET(/CT)相比,[18F]FDGPET(/CT)具有更高和平衡的灵敏度和特异性,以及它在评估骨骼外病变方面的优势,[18F]FDGPET(/CT)应该是评估BrC骨转移的首选多模态成像方法,如果有的话。