FAPI PET/CT在肿瘤学研究中的诊断准确性评价:系统回顾和荟萃分析。

IF 9.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Grayson Wass, Kari Clifford, Rathan M Subramaniam
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引用次数: 2

摘要

成纤维细胞活化蛋白是肿瘤分子成像的重要靶点。研究表明,成纤维细胞活化蛋白抑制剂(FAPI)放射性示踪剂在各种癌症中具有良好的肿瘤与背景比,是准确的诊断方法。因此,我们进行了系统回顾和荟萃分析,以评估FAPI PET/CT与[18F]FDG PET/CT的诊断性能,FAPI PET/CT是肿瘤学中使用最广泛的放射性示踪剂。方法:系统检索MEDLINE、Embase、Scopus、PubMed、Cochrane Central Register of Controlled Trials、相关试验注册库和参考文献。搜索包括三个主题的术语组合:肿瘤、PET/CT和FAPI。两位作者使用预定义的纳入和排除标准独立筛选检索到的文章,并提取数据。使用QUADAS-2(诊断准确性研究质量评估2)的标准评估研究质量。对于每项研究,计算敏感性、特异性和95% ci,以确定原发性、淋巴结性和转移性病变的诊断准确性。采用随机效应荟萃分析合并数据,并评估异质性(I2指数)。结果:39项研究(1259例患者)调查了FAPI PET/CT的使用。在基于患者的分析中,检测原发病变的总敏感性为0.99 (95% CI, 0.97-1.0)。淋巴结转移和远处转移的总敏感性分别为0.91 (95% CI, 0.81-0.96)和0.99 (95% CI, 0.96-1.0)。在FAPI与[18F]FDG PET/CT的配对分析中,FAPI在检测原发性、淋巴结性和转移性病变方面具有更高的敏感性(所有p18f]FDG均具有统计学意义)。在异质性方面,原发病变的分析受到中度影响,远处转移病变受到高度影响,而淋巴结转移分析的异质性可以忽略不计。结论:FAPI PET/CT对原发性、淋巴结性和远处转移的诊断能力优于[18F]FDG。然而,需要进一步的研究来更好地评估其在特定癌症类型和临床环境中的效用和适应症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the Diagnostic Accuracy of FAPI PET/CT in Oncologic Studies: Systematic Review and Metaanalysis.

Fibroblast-activation protein is a promising target for oncologic molecular imaging. Studies show that fibroblast activation protein inhibitor (FAPI) radiotracers are accurate diagnostics with favorable tumor-to-background ratios across various cancers. Therefore, we performed a systematic review and metaanalysis to assess the diagnostic performance of FAPI PET/CT in comparison with [18F]FDG PET/CT, the most widely used radiotracer in oncology. Methods: We conducted a systematic search in MEDLINE, Embase, Scopus, PubMed, Cochrane Central Register of Controlled Trials, relevant trial registries, and bibliographies. The search consisted of combinations of terms for 3 topics: neoplasia, PET/CT, and FAPI. Two authors independently screened retrieved articles using predefined inclusion and exclusion criteria and extracted the data. Study quality was assessed using the criteria of QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2). For each study, the sensitivity, specificity, and 95% CIs were calculated to determine diagnostic accuracy for primary, nodal, and metastatic lesions. A random-effects metaanalysis was used for pooling the data, and heterogeneity was assessed (I2 index). Results: Thirty-nine studies (1,259 patients) investigating the use of FAPI PET/CT were included. On a patient-based analysis, pooled sensitivity was 0.99 (95% CI, 0.97-1.0) for the detection of primary lesions. Pooled sensitivity for nodal and distant metastases was 0.91 (95% CI, 0.81-0.96) and 0.99 (95% CI, 0.96-1.0), respectively. On a paired analysis between FAPI and [18F]FDG PET/CT, FAPI had a higher sensitivity in the detection of primary, nodal, and metastatic lesions (all P < 0.001). The differences in sensitivities between FAPI and [18F]FDG were statistically significant. In terms of heterogeneity, analyses on primary lesions were moderately affected, distant metastatic lesions were highly affected, and the nodal metastatic analyses had negligible heterogeneity. Conclusion: The diagnostic performance of FAPI PET/CT is superior to that of [18F]FDG in the detection of primary, nodal, and distant metastases. However, further studies are needed to better evaluate its utility and indication in specific cancer types and clinical settings.

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来源期刊
Journal of Nuclear Medicine
Journal of Nuclear Medicine 医学-核医学
CiteScore
13.00
自引率
8.60%
发文量
340
审稿时长
1 months
期刊介绍: The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.
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