背景:18F-氟脱氧葡萄糖(FDG)PET/CT正在成为诊断和评估肺结节病的工具,然而,关于其诊断性能和预后价值的共识有限.
方法:使用PubMed进行了荟萃分析,科学直接,MEDLINE,Scopus,和CENTRAL数据库搜索到并包括2023年9月。筛选了1355项研究,根据他们对FDG-PET/CT的诊断性能或预后价值的评估,有17例(n=708例)适合。使用QUADAS-2工具评估研究质量。生成汇总敏感性和特异性的森林图以评估诊断性能。SUVmax的合并变化与肺功能测试(PFT)的变化相关。
结果:FDG-PET/CT诊断可疑肺结节病(六项研究,n=400)的合并敏感性为0.971(95CI0.909-1.000,p=<0.001),特异性为0.873(95CI0.845-0.920)(一项研究,n=169)。11项预后分析研究(n=308)表明,治疗后肺SUVmax降低4.538(95CI5.653-3.453,p=<0.001)。PFTs显示治疗后改善,预测的强制肺活量(FVC)和肺对一氧化碳的弥散能力(DLCO)增加了7.346%(95CI2.257-12.436,p=0.005)和3.464%(95CI-0.205-7.132,p=0.064),分别。SUVmax的降低与FVC(r=0.644,p<0.001)和DLCO(r=0.582,p<0.001)的改善显著相关。
结论:在疑似肺结节病的病例中,FDG-PET/CT表现出良好的诊断性能,并与功能健康评分相关。FDG-PET/CT可能有助于指导复杂结节病或需要合理化治疗的免疫抑制。
结论:FDG-PET/CT在评估可疑肺结节病方面具有很高的诊断性能,放射学评估的疾病活动与临床衍生的肺功能检查密切相关。
结论:在诊断肺结节病时,FDG-PET/CT的敏感性和特异性分别为0.971和0.873。疾病活动,由SUVmax确定,在所有纳入的研究中,治疗后减少。SUVmax的降低与功能肺活量的改善相关,肺对一氧化碳的扩散能力,和主观健康评分系统。
BACKGROUND: 18F-Fluorodeoxyglucose (FDG) PET/CT is emerging as a tool in the diagnosis and evaluation of
pulmonary sarcoidosis, however, there is limited consensus regarding its diagnostic performance and prognostic value.
METHODS: A meta-analysis was conducted with PubMed, Science Direct, MEDLINE, Scopus, and CENTRAL databases searched up to and including September 2023. 1355 studies were screened, with seventeen (n = 708 patients) suitable based on their assessment of the diagnostic performance or prognostic value of FDG-PET/CT. Study quality was assessed using the QUADAS-2 tool. Forest plots of pooled sensitivity and specificity were generated to assess diagnostic performance. Pooled changes in SUVmax were correlated with changes in
pulmonary function tests (PFT).
RESULTS: FDG-PET/CT in diagnosing suspected
pulmonary sarcoidosis (six studies, n = 400) had a pooled sensitivity of 0.971 (95%CI 0.909-1.000, p = < 0.001) and specificity of 0.873 (95%CI 0.845-0.920)(one study, n = 169). Eleven studies for prognostic analysis (n = 308) indicated a pooled reduction in
pulmonary SUVmax of 4.538 (95%CI 5.653-3.453, p = < 0.001) post-treatment. PFTs displayed improvement post-treatment with a percentage increase in predicted forced vital capacity (FVC) and diffusion capacity of the lung for carbon monoxide (DLCO) of 7.346% (95%CI 2.257-12.436, p = 0.005) and 3.464% (95%CI -0.205-7.132, p = 0.064), respectively. Reduction in SUVmax correlated significantly with FVC (r = 0.644, p < 0.001) and DLCO (r = 0.582, p < 0.001) improvement.
CONCLUSIONS: In cases of suspected pulmonary sarcoidosis, FDG-PET/CT demonstrated good diagnostic performance and correlated with functional health scores. FDG-PET/CT may help to guide immunosuppression in cases of complex sarcoidosis or where treatment rationalisation is needed.
CONCLUSIONS: FDG-PET/CT has demonstrated a high diagnostic performance in the evaluation of suspected pulmonary sarcoidosis with radiologically assessed disease activity correlating strongly with clinically derived pulmonary function tests.
CONCLUSIONS: In diagnosing
pulmonary sarcoidosis, FDG-PET/CT had a sensitivity and specificity of 0.971 and 0.873, respectively. Disease activity, as determined by SUVmax, reduced following treatment in all the included studies. Reduction in SUVmax correlated with an improvement in functional vital capacity, Diffusion Capacity of the Lungs for Carbon Monoxide, and subjective health scoring systems.