Purpose： To determine the diagnostic performance of 3＇-deoxy-3＇-18F-fluorothymidine positron emission tomography/computed tomography（FLT PET/CT） and FLT PET for evaluating response to chemotherapy in patients wit...Purpose： To determine the diagnostic performance of 3＇-deoxy-3＇-18F-fluorothymidine positron emission tomography/computed tomography（FLT PET/CT） and FLT PET for evaluating response to chemotherapy in patients with breast cancer.Methods： Databases such as Pub Med（MEDLINE included） and excerpta medica database（EMBASE）, were searched for relevant original articles. The included studies were assessed for methodological quality with quality assessment of diagnosis accuracy studies（QUADAS） score tool. Histopathological analysis and/or clinical and/or radiological follow-up for at least 6 months were used as the reference standard. The data were extracted by two reviewers independently to analyze the sensitivity, specificity, summary receiver operating characteristic（SROC） curve, area under the curve（AUC）, and heterogeneity.Results： The present study analyzed a total of 4 selected articles. The pool sensitivity was 0.773 [95% confidence interval（CI）： 0.594-0.900]. The pooled specificity was 0.685（95% CI： 0.479-0.849） on basis of FEM. The pooled LR^＋, LR^-, and DOR were 2.874（1.492-5.538）, 0.293（0.146-0.589）, and 14.891（3.238-68.475）, respectively. The AUC was 0.8636（±0.0655）, and the Q＊ index was 0.7942（±0.0636）.Conclusions： Our results indicate that 18^F-FLT PET/CT or PET is useful to predict chemotherapy response in breast cancer with reasonable sensitivity, specificity and DOR. However, future larger scale clinical trials will be needed to assess the regimen of 18^F-FLT PET/CT or PET in monitoring the response to chemotherapy in breast cancer patients.展开更多
基金supported by the Open Program of Key Laboratory of Nuclear Medicine, Ministry of Health and Jiangsu Key Laboratory of Molecular Nuclear Medicine (KF201305 and KF201306)Science and Technology Development Program of Suzhou (SYSD2013076)
文摘Purpose： To determine the diagnostic performance of 3＇-deoxy-3＇-18F-fluorothymidine positron emission tomography/computed tomography（FLT PET/CT） and FLT PET for evaluating response to chemotherapy in patients with breast cancer.Methods： Databases such as Pub Med（MEDLINE included） and excerpta medica database（EMBASE）, were searched for relevant original articles. The included studies were assessed for methodological quality with quality assessment of diagnosis accuracy studies（QUADAS） score tool. Histopathological analysis and/or clinical and/or radiological follow-up for at least 6 months were used as the reference standard. The data were extracted by two reviewers independently to analyze the sensitivity, specificity, summary receiver operating characteristic（SROC） curve, area under the curve（AUC）, and heterogeneity.Results： The present study analyzed a total of 4 selected articles. The pool sensitivity was 0.773 [95% confidence interval（CI）： 0.594-0.900]. The pooled specificity was 0.685（95% CI： 0.479-0.849） on basis of FEM. The pooled LR^＋, LR^-, and DOR were 2.874（1.492-5.538）, 0.293（0.146-0.589）, and 14.891（3.238-68.475）, respectively. The AUC was 0.8636（±0.0655）, and the Q＊ index was 0.7942（±0.0636）.Conclusions： Our results indicate that 18^F-FLT PET/CT or PET is useful to predict chemotherapy response in breast cancer with reasonable sensitivity, specificity and DOR. However, future larger scale clinical trials will be needed to assess the regimen of 18^F-FLT PET/CT or PET in monitoring the response to chemotherapy in breast cancer patients.
文摘目的:应用循证医学及Meta分析方法评估18F-脱氧葡萄糖(fluorodeoxyglucose,FDG)和18 F-脱氧胸腺嘧啶核苷(fluorothymidine,FLT)正电子发射断层扫描(positron emission tomography,PET)在肺恶性结节诊断中的价值。方法:检索PubMed、Ovid、Cochrane图书馆、CNKI、万方数据库和中文科技期刊数据库等,依据纳入及排除标准筛选文献,按照诊断精确性研究的质量鉴定(quality assessment of studies of diagnostic accuracy included in systematic reviews,QUADAS)标准行质量评价,提取数据并用Meta-disc 1.4软件行Meta分析,计算合并敏感度、合并特异度、汇总受试者工作曲线(summary receiver-operating characteristic curves,SROC)及曲线下面积(areas under the curve,AUC)等。结果:最终纳入7篇文献。FDG PET敏感度为0.844,95%CI:0.791~0.888,特异度仅为0.477,95%CI:0.405~0.549;FLT PET敏感度为0.784,95%CI:0.725~0.835,特异度为0.677,95%CI:0.606~0.742;FDG和FLT的SROC AUC分别为0.757 0和0.820 1,P=0.273。结论:FDG PET对肺部恶性病变敏感性很高但特异度差,FLT PET敏感性和特异度较均衡;在肺部恶性肿瘤的诊断中,FLT尚不能代替FDG的应用;FDG PET的优势在于探寻隐匿的肿瘤病灶和肿瘤分期等方面;FLT PET的优势在于减少炎性反应所致的假阳性结果。
