Diagnostic performance of 2-[¹⁸F]FDG PET/CT in recurrent differentiated thyroid cancer and elevated antithyroglobulin antibodies: an updated systematic review and bivariate meta-analysis.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-09 DOI:10.1007/s12020-024-03989-9

Domenico Albano, Arnoldo Piccardo, Alessio Rizzo, Marco Cuzzocrea, Gianluca Bottoni, Pietro Bellini, Francesco Bertagna, Giorgio Treglia

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Abstract

Purpose: This updated systematic review and bivariate meta-analysis aimed to investigate the diagnostic performance of 2-[¹⁸F]FDG PET/CT for the detection of recurrent disease in patients with differentiated thyroid cancer (DTC) who have negative ¹³¹I whole body scintigraphy and increased antithyroglobulin antibodies (TgAb) levels.

Methods: The current systematic review was carried out following a preset protocol, and the "Preferred Reporting Items for a Systematic Review and Meta-Analysis" served as a guideline for its development and reporting. A comprehensive research of the PubMed/MEDLINE, Embase and Cochrane library databases was conducted until June 2024.

Results: Between 2002 and 2023, 13 studies (608 patients) published on this topic were selected. The pooled sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 2-[¹⁸F]FDG PET or PET/CT were 84% (95%CI: 78-87%), 82% (95%CI: 78-86%), 72% (95%CI: 67-76%), 90% (95%CI: 87-93%) and 83% (95%CI: 79%-86%) respectively. The pooled positive and negative likelihood ratios (LR+ and LR - ) and the diagnostic odds ratio (DOR) were 0.180 (95%CI: 0.128-0.253), 3.214 (95%CI: 2.357-4.383), and 17.863 (95%CI: 10.475-30.462), respectively. No statistically significant heterogeneity among the studies was found for all the metrics evaluated (I² < 50%).

Conclusions: 2-[¹⁸F]FDG PET/CT demonstrated a good diagnostic performance in patients with DTC and increased TgAb. Although more studies are warranted, the provided evidence-based data should support the integration of 2-[¹⁸F]FDG PET/CT in clinical and diagnostic guidelines on DTC patients with increased TgAb.

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2-[18F]FDG PET/CT 对复发性分化型甲状腺癌和抗甲状腺球蛋白抗体升高的诊断效果：最新系统综述和双变量荟萃分析。

目的：这项最新的系统综述和双变量荟萃分析旨在研究2-[18F]FDG PET/CT对131I全身闪烁扫描阴性且抗甲状腺球蛋白抗体（TgAb）水平升高的分化型甲状腺癌（DTC）患者检测复发疾病的诊断性能：本次系统综述是按照预设方案进行的，"系统综述和荟萃分析首选报告项目 "是其开发和报告的指南。截至 2024 年 6 月，我们对 PubMed/MEDLINE、Embase 和 Cochrane 图书馆数据库进行了全面研究：结果：选取了 2002 年至 2023 年间发表的 13 项相关研究（608 名患者）。2-[18F]FDG PET 或 PET/CT 的集合敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 84% (95%CI: 78-87%)、82% (95%CI: 78-86%)、72% (95%CI: 67-76%)、90% (95%CI: 87-93%) 和 83% (95%CI: 79%-86%)。汇总的阳性和阴性似然比（LR+ 和 LR - ）以及诊断几率比（DOR）分别为 0.180（95%CI：0.128-0.253）、3.214（95%CI：2.357-4.383）和 17.863（95%CI：10.475-30.462）。在所有评估指标中，各研究之间均未发现具有统计学意义的异质性（I2 结论）：2-[18F]FDG PET/CT 对 DTC 和 TgAb 增高的患者具有良好的诊断效果。尽管还需要进行更多的研究，但所提供的循证数据应支持将 2-[18F]FDG PET/CT 纳入 TgAb 增高的 DTC 患者的临床和诊断指南中。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.