^(18)F-FDOPA与^(18)F-FDG PET/CT诊断脑肿瘤的系统评价

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

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、Pub Med、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-Disc1.4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1.59(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。

Objective To compare the diagnostic value of ^18F-FDOPA and 18F-FDG PET/CT scan in patients with brain tumors by Meta analysis.Methods Data on diagnostic experiments related to the diagnostic value of ^18F-FDOPA and ^18F-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 ^18F-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-FDOPA is of high diagnostic value for brain tumors and can be used as a reliable diagnostic method of brain tumors.