Diagnostic value of ¹⁸F-FDG PET/CT and ⁶⁸Ga-FAPI PET/CT in primary liver cancer: A systematic review and meta-analysis.

IF 0.9 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Hellenic journal of nuclear medicine Pub Date : 2023-05-01 Epub Date: 2023-08-04 DOI:10.1967/s002449912575

Ma Jiao, Tang Mingsong, Jiang Hao, Zhang Chunyin

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引用次数: 0

Abstract

Objective: To conduct a meta-analysis of the diagnostic efficacy of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) and gallium-68-labeled fibroblast-activation protein inhibitor (⁶⁸Ga-FAPI) positron emission tomography/computed tomography (PET/CT) for primary liver cancer based on existing clinical evidence.

Materials and methods: Meta-analysis was carried out according to PRISMA reporting specification. The clinical studies in PubMed/Medline, Embase and the Cochrane Library database were retrieved from the establishment to September 2022. Two researchers independently conducted literature screening and data extraction, evaluated the risk of bias according to QUADAS-2, conducted meta-analysis using Meta Disc 1.4 and Stata15.1 software, and calculated the summarized sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR). The diagnostic performance of ¹⁸F-FDG PET/CT and ⁶⁸Ga-FAPI PET/CT for primary liver cancer was compared using summarized receiver operating characteristic (SROC) curve and area under curve (AUC).

Results: Four original studies on ¹⁸F-FDG PET/CT and ⁶⁸Ga-FAPI PET/CT in the diagnosis of primary liver cancer were included, including 159 intrahepatic lesions in 106 patients. Taking lesions as a unit, in four original studies, the pooled results of ¹⁸F-FDG PET/CT diagnosis of primary liver cancer were Sen=0.5 (95% CI:95% CI: 0.41-0.59), Spe=0.87 (95% CI: 0.52-0.98), AUC=0.58 (95% CI:0.53-0.62); The pooled results of ⁶⁸Ga-FAPI PET/CT in the diagnosis of primary liver cancer, Sen=0.5 (95% CI: 0.41-0.59), Spe=0.87 (95%CI:0.52-0.98), AUC=0.58 (95% CI:0.53-0.62). Besides, the Sen of ⁶⁸Ga-FAPI PET/CT in the diagnosis of primary liver cancer was higher than that of ¹⁸F-FDG PET/CT (Z=2.323, P=0.02), the difference was statistically significant.

Conclusion: Gallium-68-FAPI PET/CT is a promising tool. Compared with ¹⁸F-FDG, ⁶⁸Ga-FAPI has higher sensitivity to detect more lesions in primary liver cancer and metastatic lesions, and has high performance in the diagnosis of primary liver cancer.

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18F-FDG PET/CT和68Ga-FAPI PET/CT对原发性肝癌的诊断价值：系统综述和荟萃分析。

目的：根据现有临床证据，对氟18-氟脱氧葡萄糖（18F-FDG）和镓68-标记的成纤维细胞活化蛋白抑制剂（68Ga-FAPI）正电子发射断层扫描/计算机断层扫描（PET/CT）对原发性癌症的诊断效果进行荟萃分析。材料和方法：根据PRISMA报告规范进行荟萃分析。PubMed/Medline、Embase和Cochrane图书馆数据库中的临床研究是从建立到2022年9月检索的。两名研究人员独立进行文献筛选和数据提取，根据QUADAS-2评估偏倚风险，使用meta Disc 1.4和Stata15.1软件进行荟萃分析，并计算总结敏感性（SEN）、特异性（SPE）、阳性似然比（+LR）、阴性似然比（-LR）和诊断优势比（DOR）。应用总结受试者工作特征曲线（SROC）和曲线下面积（AUC）比较18F-FDG PET/CT和68Ga-FAPI PET/CT对原发性肝癌的诊断效果。结果：纳入4项18F-FDG PET/CT和68Ga-FAPI PET/CT在原发性肝癌诊断中的原始研究，包括106例患者的159个肝内病变。以病变为单位，在4项原始研究中，18F-FDG PET/CT诊断原发性肝癌癌症的合并结果分别为Sen=0.5（95%CI:95%CI:0.41～0.59）、Spe=0.87（95%CI:0.52～0.98）、AUC=0.58（95%CI=0.53～0.62）；68Ga-FAPI PET/CT诊断原发性肝癌的合并结果Sen=0.5（95%CI:0.41～0.59），Spe=0.87（95%CI:0.52～0.98），AUC=0.58（95%CI:0.53～0.62），68Ga-FAPIPET/CT在原发性癌症诊断中的Sen高于18F-FDG PET/CT（Z=2.323，P=0.02），差异有统计学意义。结论：镓68-FAPI PET/CT是一种很有前途的成像工具。与18F-FDG相比，68Ga-FAPI在原发性肝癌癌症和转移病灶中检测更多病灶的灵敏度更高，在诊断原发性癌症方面具有较高的表现。

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来源期刊

Hellenic journal of nuclear medicine 医学-核医学

CiteScore

1.40

自引率

6.70%

发文量

审稿时长

>12 weeks

期刊介绍： The Hellenic Journal of Nuclear Medicine published by the Hellenic Society of Nuclear Medicine in Thessaloniki, aims to contribute to research, to education and cover the scientific and professional interests of physicians, in the field of nuclear medicine and in medicine in general. The journal may publish papers of nuclear medicine and also papers that refer to related subjects as dosimetry, computer science, targeting of gene expression, radioimmunoassay, radiation protection, biology, cell trafficking, related historical brief reviews and other related subjects. Original papers are preferred. The journal may after special agreement publish supplements covering important subjects, dully reviewed and subscripted separately.