摘要
AIM: To systematically evaluate the accuracy of 18-fluorodeoxy-D-glucose-positron emission tomography(18-FDG PET) to assess response to neoadjuvant chemotherapy in bone and soft tissue sarcomas.METHODS: Studies published in English language regarding the accuracy of F-18 FDG PET for the indication were retrieved from MEDLINE.The QUADAS tool was utilized for methodological quality appraisal.Relevant data were extracted,and quantitative data synthesis included pooled estimation and subgroup analysis.RESULTS: A total of fifteen studies involving 420 patients with pathologically confirmed sarcoma were collected.Methodological quality was relatively high.The pooled sensitivity and specificity of PET to predict histopathological response were 87%(95%CI: 81%-91%) and 83%(95%CI: 77%-87%),respectively.Ten stud-ies employed a lower standardized uptake value(SUV) after chemotherapies(mostly 2.5) and/or a higher SUV reduction rate(mostly around 50%) as PET criteria of good response.Subgroup analysis showed that PET exhibited a significantly better specificity in osteosarcoma(OS) and Ewing sarcoma(ES) than in soft-tissue sarcoma(STS)(91% vs 75%,P < 0.05),and a higher specificity in pediatric patients than in adults(90% vs 74%,P < 0.01).PET yielded a lower specificity in ifosfamidecontained chemotherapies than in the alternative regimen(70% vs 97%,P < 0.01).CONCLUSION: F-18 FDG PET is promising to predict neoadjuvant therapy response in sarcoma,especially in pediatric patients with OS or ES.Certain chemotherapeutic agents could potentially cause false positives of PET.
AIM： To systematically evaluate the accuracy of 18-fu-orodeoxy-D-glucose-positron emission tomography （18-FDG PET） to assess response to neoadjuvant che-motherapy in bone and soft tissue sarcomas.METHODS： Studies published in English language re-garding the accuracy of F-18 FDG PET for the indication were retrieved from MEDLINE. The QUADAS tool was utilized for methodological quality appraisal. Relevant data were extracted, and quantitative data synthesis included pooled estimation and subgroup analysis. RESULTS： A total of ffteen studies involving 420 pa-tients with pathologically confrmed sarcoma were col-lected. Methodological quality was relatively high. The pooled sensitivity and specifcity of PET to predict histo-pathological response were 87% （95%CI： 81%-91%） and 83% （95%CI： 77%-87%）, respectively. Ten stud-ies employed a lower standardized uptake value （SUV） after chemotherapies （mostly 2.5） and/or a higher SUV reduction rate （mostly around 50%） as PET criteria of good response. Subgroup analysis showed that PET ex-hibited a signifcantly better specifcity in osteosarcoma （OS） and Ewing sarcoma （ES） than in soft-tissue sarco-ma （STS） （91% vs 75%, P 〈 0.05）, and a higher speci-fcity in pediatric patients than in adults （90% vs 74%, P 〈 0.01）. PET yielded a lower specifcity in ifosfamide-contained chemotherapies than in the alternative regi-men （70% vs 97%, P 〈 0.01）.CONCLUSION： F-18 FDG PET is promising to predict neoadjuvant therapy response in sarcoma, especially in pediatric patients with OS or ES. Certain chemothera-peutic agents could potentially cause false positives of PET.
基金
Supported by Scientific Research Subject of Health Department of Sichuan,China,No.070045
