双时相18F-FDG PET鉴别肺部良恶性病变准确性的Meta分析_《中国循证医学杂志》

作者：

王海军 , 李彦彦 , 王慧春 , 翟亚楠 , 庄贵学 ,  王玉斌

甘肃省人民医院核医学科（兰州　730000）;

关键词：

双时相扫描 18F-FDG PET 肺部病变鉴别诊断 Meta分析诊断性试验

DOI：

10.7507/1672-2531.20130228

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　对18F-FDG PET双时相扫描方法鉴别肺部良恶性病变的准确性进行系统评价，明确双时相扫描的必要性和临床价值。
方法　计算机检索PubMed、EMbase、The Cochrane Library、WanFang Data、CNKI和CBM数据库，检索时限从1990年1月至2011年11月，纳入18F-FDG PET双时相扫描与金标准（手术式穿刺活检结果）比较鉴别肺部良恶性病变的诊断性试验。由2位研究者按纳入与排除标准进行文献筛选、资料提取与纳入研究的方法学质量评价后，计算其敏感度与特异度合并效应量以及受试者工作特征曲线下面积（AUC），并进行敏感性分析和亚组分析。
结果　共纳入19篇文献，包括1 225个病灶。Meta分析结果显示：双时相18F-FDG PET鉴别肺部良恶性病变的敏感度为0.82［95%CI（0.79，0.85）］，特异度为0.74［95%CI（0.71，0.78）］，AUC为0.837 5。敏感性分析结果显示：① 剔除结核病变占良性病变比例 gt;50%的研究，合并敏感度为0.81［95%CI（0.77，0.84）］，特异度为0.76［95%CI（0.72，0.80）］，AUC为0.850 3；② 剔除样本量 lt;50例的研究，合并敏感度为0.78［95%CI（0.74，0.82）］，特异度为0.78［95%CI（0.74，0.82）］，AUC为0.814 1；③ 剔除iSUV（首次标准摄取值） gt;2.5的研究，合并敏感度为0.67［95%CI（0.55，0.78）］，特异度为0.66［95%CI（0.54，0.77）］，AUC为0.779 8。
结论　18F-FDG PET双时相扫描具有中等诊断价值，跟单时相扫描相比不具有优势，双时相扫描不必作为常规检查应用于临床。

引用本文： 王海军,李彦彦,王慧春,翟亚楠,庄贵学,王玉斌. 双时相18F-FDG PET鉴别肺部良恶性病变准确性的Meta分析. 中国循证医学杂志, 2013, 13(11): 1326-1332. doi: 10.7507/1672-2531.20130228 复制

1.	Whiting PF, Weswood ME, Rutjes AW, et al. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版). 中国循证医学杂志, 2007, 7(7): 531-536.
2.	Alkhawaldeh K, Bural G, Kumar R, et al. Impact of dual-time-point (18)F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules. Eur J Nucl Med Mol Imaging, 2008, 35(2): 246-252.
3.	Chen CJ, Lee BF, Yao WJ, et al. Dual-phase 18F-FDG PET in the diagnosis of pulmonary nodules with an initial standard uptake value less than 2.5. AJR Am J Roentgenol, 2008, 191(2): 475-479.
4.	Cloran FJ, Banks KP, Song WS, et al. Limitations of dual time point PET in the assessment of lung nodules with low FDG avidity. Lung Cancer, 2010, 68(1): 66-71.
5.	Demura Y, Tsuchida T, Ishizaki T, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med, 2003, 44(4): 540-548.
6.	Kaplan GH, Yildiz A, Ozbudak O, et al. Comparative value of SUVmax, dual time point imaging and non-attenuation corrected images in PET/CT in the evaluation of solitary pulmonary nodule. Eur J Nucl Med Mol Imaging, 2011, 38S361.
7.	Laffon E, de Clermont H, Begueret H, et al. Assessment of dual-time-point 18F-FDG-PET imaging for pulmonary lesions. Nucl Med Commun, 2009, 30(6): 455-461.
8.	Lan XL, Zhang YX, Wu ZJ, et al. The value of dual time point (18)F-FDG PET imaging for the differentiation between malignant and benign lesions. Clin Radiol, 2008, 63(7): 756-764.
9.	Macdonald K, Searle J, Lyburn I. The role of dual time point FDG PET imaging in the evaluation of solitary pulmonary nodules with an initial standard uptake value less than 2.5. Clin Radiol, 2011, 66(3): 244-250.
10.	Matthies A, Hickeson M, Cuchiara A, et al. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med, 2002, 43(7): 871-875.
11.	Nunez R, Kalapparambath A, Varela J. Improvement in sensitivity with delayed imaging of pulmonary lesions with FDG-PET. Rev Esp Med Nucl, 2007, 26(4): 196-207.
12.	Sathekge MM, Maes A, Pottel H, et al. Dual time-point FDG PET/CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area. South African Medical Journal, 2010, 100(9): 598-601.
13.	Schillaci O, Travascio L, Bolacchi F, et al. Accuracy of early and delayed FDG PET-CT and of contrast-enhanced CT in the evaluation of lung nodules: a preliminary study on 30 patients. Radiol Med, 2009, 114(6): 890-906.
14.	Suga K, Kawakami Y, Hiyama A, et al. Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions. Ann Nucl Med, 2009, 23(5): 427-435.
15.	王跃涛, 刘德峰, 钱作宾, 等. F18-FDG PET/CT双时相显像对肺部病灶的定性诊断价值. 中华核医学杂志, 2009, 29(5): 293-296.
16.	姚稚明, 屈婉莹, 刘甫庚, 等. 18F-FDG PET/CT双时相显像对孤立性肺结节的诊断价值. 中华核医学杂志, 2007, 27(1): 5-7.
17.	Xiu Y, Bhutani C, Dhurairaj T, et al. Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity. Clin Nucl Med, 2007, 32(2): 101-105.
18.	杨鹏, 龚静山, 陈立光, 等. 双时相～(18)F-FDG PET鉴别诊断肺内良恶性病变的价值. 中国医学影像技术, 2011, 27(10): 2017-2020.
19.	赵秀娟, 赵新明, 王建方, 等. 18F-FDG PET/CT双时相显像鉴别诊断肺良恶性病变的临床研究. 肿瘤学杂志, 2011, 17(10): 736-740.
20.	周克, 吴平, 陈治明, 等. F18-FDG双时相显影在肺结节病灶中的应用. 西南国防医药, 2011, 21(10): 1079-1081.
21.	Gould MK, Maclean CC, Kuschner WG, et al. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA, 2001, 285(7): 914-924.

1. Whiting PF, Weswood ME, Rutjes AW, et al. QUADAS评价:一种用于诊断性研究的质量评价工具(修订版). 中国循证医学杂志, 2007, 7(7): 531-536.
2. Alkhawaldeh K, Bural G, Kumar R, et al. Impact of dual-time-point (18)F-FDG PET imaging and partial volume correction in the assessment of solitary pulmonary nodules. Eur J Nucl Med Mol Imaging, 2008, 35(2): 246-252.
3. Chen CJ, Lee BF, Yao WJ, et al. Dual-phase 18F-FDG PET in the diagnosis of pulmonary nodules with an initial standard uptake value less than 2.5. AJR Am J Roentgenol, 2008, 191(2): 475-479.
4. Cloran FJ, Banks KP, Song WS, et al. Limitations of dual time point PET in the assessment of lung nodules with low FDG avidity. Lung Cancer, 2010, 68(1): 66-71.
5. Demura Y, Tsuchida T, Ishizaki T, et al. 18F-FDG accumulation with PET for differentiation between benign and malignant lesions in the thorax. J Nucl Med, 2003, 44(4): 540-548.
6. Kaplan GH, Yildiz A, Ozbudak O, et al. Comparative value of SUVmax, dual time point imaging and non-attenuation corrected images in PET/CT in the evaluation of solitary pulmonary nodule. Eur J Nucl Med Mol Imaging, 2011, 38S361.
7. Laffon E, de Clermont H, Begueret H, et al. Assessment of dual-time-point 18F-FDG-PET imaging for pulmonary lesions. Nucl Med Commun, 2009, 30(6): 455-461.
8. Lan XL, Zhang YX, Wu ZJ, et al. The value of dual time point (18)F-FDG PET imaging for the differentiation between malignant and benign lesions. Clin Radiol, 2008, 63(7): 756-764.
9. Macdonald K, Searle J, Lyburn I. The role of dual time point FDG PET imaging in the evaluation of solitary pulmonary nodules with an initial standard uptake value less than 2.5. Clin Radiol, 2011, 66(3): 244-250.
10. Matthies A, Hickeson M, Cuchiara A, et al. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med, 2002, 43(7): 871-875.
11. Nunez R, Kalapparambath A, Varela J. Improvement in sensitivity with delayed imaging of pulmonary lesions with FDG-PET. Rev Esp Med Nucl, 2007, 26(4): 196-207.
12. Sathekge MM, Maes A, Pottel H, et al. Dual time-point FDG PET/CT for differentiating benign from malignant solitary pulmonary nodules in a TB endemic area. South African Medical Journal, 2010, 100(9): 598-601.
13. Schillaci O, Travascio L, Bolacchi F, et al. Accuracy of early and delayed FDG PET-CT and of contrast-enhanced CT in the evaluation of lung nodules: a preliminary study on 30 patients. Radiol Med, 2009, 114(6): 890-906.
14. Suga K, Kawakami Y, Hiyama A, et al. Dual-time point 18F-FDG PET/CT scan for differentiation between 18F-FDG-avid non-small cell lung cancer and benign lesions. Ann Nucl Med, 2009, 23(5): 427-435.
15. 王跃涛, 刘德峰, 钱作宾, 等. F18-FDG PET/CT双时相显像对肺部病灶的定性诊断价值. 中华核医学杂志, 2009, 29(5): 293-296.
16. 姚稚明, 屈婉莹, 刘甫庚, 等. 18F-FDG PET/CT双时相显像对孤立性肺结节的诊断价值. 中华核医学杂志, 2007, 27(1): 5-7.
17. Xiu Y, Bhutani C, Dhurairaj T, et al. Dual-time point FDG PET imaging in the evaluation of pulmonary nodules with minimally increased metabolic activity. Clin Nucl Med, 2007, 32(2): 101-105.
18. 杨鹏, 龚静山, 陈立光, 等. 双时相～(18)F-FDG PET鉴别诊断肺内良恶性病变的价值. 中国医学影像技术, 2011, 27(10): 2017-2020.
19. 赵秀娟, 赵新明, 王建方, 等. 18F-FDG PET/CT双时相显像鉴别诊断肺良恶性病变的临床研究. 肿瘤学杂志, 2011, 17(10): 736-740.
20. 周克, 吴平, 陈治明, 等. F18-FDG双时相显影在肺结节病灶中的应用. 西南国防医药, 2011, 21(10): 1079-1081.
21. Gould MK, Maclean CC, Kuschner WG, et al. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA, 2001, 285(7): 914-924.

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双时相18F-FDG PET鉴别肺部良恶性病变准确性的Meta分析

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《中国循证医学杂志》

双时相18F-FDG PET鉴别肺部良恶性病变准确性的Meta分析

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