用于评估宫颈癌妇女淋巴结转移的扩散加权成像：表观扩散系数值的 Meta 分析。

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2025-03-01 DOI:10.1016/j.acra.2024.09.020

Robyn F. Distelbrink , Enise Celebi , Constantijne H. Mom , Jaap Stoker , Shandra Bipat

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引用次数: 0

摘要

目的：评估扩散加权成像（DWI）的诊断性能，并提供区分子宫颈癌妇女良性和转移性淋巴结的最佳表观扩散系数（ADC）临界值：方法：检索了 MEDLINE 和 EMBASE 数据库。采用 QUADAS-2 评估方法学质量。对三个分组进行了数据分析：(1) 所有研究；(2) 最大 b 值为 800 s/mm² 的研究；(3) b 值为 1000 s/mm² 的研究。构建接收者工作特征曲线（ROC）并计算曲线下面积（AUC）。在计算灵敏度和特异性后，使用最大尤登指数确定最佳 ADC 截断值：结果：共纳入 16 篇文章（1156 名患者）。总体而言，这些文章的质量有限。综合所有研究，最佳 ADC 临界值为 0.985×10-³ mm²/s，最大尤登指数为 0.77，灵敏度和特异度分别为 84% 和 94%。b 值高达 800 s/mm² 的研究得出的最佳 ADC 临界值为 0.985×10-³ mm²/s（尤登指数最大值为 0.62），灵敏度和特异性分别为 62% 和 100%。b值为1000 s/mm²的研究得出的最佳ADC临界值为0.9435×10-³ mm²/s（尤登指数最大值为0.93），敏感性和特异性分别为100%和93%：结论：与b值不超过800 s/mm²的研究相比，使用b值为1000 s/mm²的DWI研究具有更高的灵敏度和特异性。截止值为 0.9435×10-³ mm²/s 的 DWI 能够充分区分良性淋巴结和转移性淋巴结。

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Diffusion Weighted Imaging for the Assessment of Lymph Node Metastases in Women with Cervical Cancer: A Meta-analysis of the Apparent Diffusion Coefficient Values

Purpose

To assess the diagnostic performance of Diffusion Weighted Imaging (DWI) and provide optimal apparent diffusion coefficient (ADC) cut-off values for differentiating between benign and metastatic lymph nodes in women with uterine cervical cancer.

Method

MEDLINE and EMBASE databases were searched. Methodological quality was assessed with QUADAS-2. Data analysis was performed for three subgroups: (1) All studies; (2) Studies with maximum b-values of 800 s/mm², and (3) Studies containing b-values of 1000 s/mm². Receiver-operating characteristics (ROC) curves were constructed and the area under the curve (AUC) was calculated. The maximum Youden index was used to determine optimal ADC cut-off values, following calculations of sensitivity and specificity.

Results

16 articles (1156 patients) were included. Overall, their quality was limited. For all studies combined, the optimum ADC cut-off value was 0.985 × 10⁻³ mm²/s at maximum Youden Index of 0.77, resulting in sensitivity and specificity of 84%, and 94%, respectively. Studies with b-values up to 800 s/mm², gave an optimum ADC cut-off value of 0.985 × 10⁻³ mm²/s at maximum Youden Index of 0.62, with a sensitivity and specificity of 62%, and 100%. Studies containing b-values of 1000 s/mm² gave an optimum ADC cut-off value of 0.9435 × 10⁻³ mm²/s at maximum Youden Index of 0.93, with a sensitivity and specificity of 100%, and 93%, respectively.

Conclusion

Studies using DWI including b-values of 1000 s/mm² have higher sensitivity and specificity than those with b-values up to 800 s/mm². At the cut-off value of 0.9435 × 10⁻³ mm²/s DWI can sufficiently discriminate between benign and metastatic lymph nodes.

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.