BACKGROUND & AIMS:
OBJECTIVE:The objective of this study was to evaluate the overall diagnostic value of PET(CT) in patients with neuroblastoma (NB) based on qualified studies.
METHODS:PubMed, Cochrane, and Embase database were searched by the index words to identify the qualified studies, and relevant literature sources were also searched. The latest research was performed in April 2019. Heterogeneity of the included studies was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were also performed.
RESULTS:Eleven studies with 580 patients were involved in the meta-analysis to explore the diagnostic accuracy of PET(CT) for NB. PET(CT) has high diagnostic accuracy of NB: the global sensitivity was 91% (95% confidence interval [CI], 86%-94%), the global specificity was 78% (95% CI, 66%-86%), the global positive likelihood ratio was 4.07 (95% CI, 2.54-6.50), the global negative likelihood ratio was 0.12 (95% CI, 0.08-0.18), the global DOR was 27.43 (95% CI, 14.45-52.07), and the area under the SROC was high (area under the curve, 0.93; 95% CI, 0.90-0.95). Besides this, PET(CT) has high diagnostic accuracy of primary NB: the global sensitivity was 86% (95% CI, 73%-93%), the global specificity was 82% (95% CI, 57%-94%), the global positive likelihood ratio was 4.90 (95% CI, 1.63-14.72), the global negative likelihood ratio was 0.17 (95% CI, 0.07-0.40), the global DOR was 25.427 (95% CI, 3.988-162.098), and the area under the SROC was high (area under the curve, 0.91; 95% CI, 0.88-0.93). However, there has no significant accuracy of PET(CT) in NB with bone marrow.
CONCLUSIONS:This study provides a systematic review and meta-analysis of diagnostic accuracy studies of PET(CT) for NB. The results indicated that PET(CT) is a highly accurate diagnostic tool for NB.
背景与目标:
目的:本研究的目的是根据合格研究评估PET(CT)对神经母细胞瘤(NB)患者的总体诊断价值。
方法:通过关键词检索PubMed,Cochrane和Embase数据库,以鉴定合格的研究,并检索相关文献来源。最新研究于2019年4月进行。对纳入研究的异质性进行了测试,用于选择适当的效应模型以计算合并的加权敏感性,特异性和诊断比值比(DOR)。还进行了摘要接收器工作特性(SROC)分析。
结果:11项研究对580例患者进行了荟萃分析,以探讨PET(CT)对NB的诊断准确性。 PET(CT)对NB的诊断准确性很高:总体敏感性为91%(95%置信区间[CI],86%-94%),总体特异性为78%(95%CI,66%-86%) ,全局正似然比为4.07(95%CI,2.54-6.50),全局负似然比为0.12(95%CI,0.08-0.18),全局DOR为27.43(95%CI,14.45-52.07), SROC下的面积较高(曲线下的面积为0.93; 95%CI为0.90-0.95)。除此之外,PET(CT)对原发性NB的诊断准确性很高:整体敏感性为86%(95%CI,73%-93%),整体特异性为82%(95%CI,57%-94%) ,全局正似然比为4.90(95%CI,1.63-14.72),全局负似然比为0.17(95%CI,0.07-0.40),全局DOR为25.427(95%CI,3.988-162.098), SROC下的面积较高(曲线下的面积为0.91; 95%CI为0.88-0.93)。但是,在患有骨髓的NB患者中,PET(CT)的准确性不高。
结论:本研究提供了对PET(CT)NB诊断准确性研究的系统评价和荟萃分析。结果表明,PET(CT)是用于NB的高度准确的诊断工具。