The Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Differentiated Thyroid Cancer Patients with Elevated Thyroglobulin/Thyroglobulin Antibody Levels and Negative Iodine Scintigraphy: A Systematic Review and Meta-Analysis

被引:8
作者
Bang, Ji-In [1 ]
Park, Sohyun [2 ]
Kim, Keunyong [3 ,4 ,5 ]
Seo, Youngduk [6 ]
Chong, Ari [7 ]
Hong, Chae Moon [8 ]
Choi, Miyoung [9 ]
Lee, Sang-Woo [10 ,11 ]
Oh, So Won [12 ]
机构
[1] CHA Univ, CHA Bundang Med Ctr, Dept Nucl Med, Gyeonggi Do, South Korea
[2] Natl Canc Ctr Res Inst & Hosp, Dept Nucl Med, Gyeonggi Do, South Korea
[3] Pusan Natl Univ, Pusan Natl Univ Hosp, Dept Nucl Med, Pusan, South Korea
[4] Pusan Natl Univ, Pusan Natl Univ Hosp, Biomed Res Inst, Pusan, South Korea
[5] Pusan Natl Univ, Sch Med, Pusan, South Korea
[6] Chungnam Natl Univ, Sejong Hosp, Dept Nucl Med, Sejong, South Korea
[7] Chosun Univ, Sch Med, Dept Nucl Med, Gwangju, South Korea
[8] Kyungpook Natl Univ, Sch Med, Dept Nucl Med, Daegu, South Korea
[9] Natl Evidence Based Healthcare Collaborating Agcy, Div Healthcare Technol Assessment Res, Seoul, South Korea
[10] Kyungpook Natl Univ, Sch Med, Dept Nucl Med, Daegu, South Korea
[11] Chilgok Hosp, Daegu, South Korea
[12] Seoul Natl Univ, Boramae Med Ctr, Dept Nucl Med, 20 Boramae Ro 5 Gil, Seoul 07061, South Korea
关键词
F-18-fluorodeoxyglucose; meta-analysis; positron emission tomography/computed tomography; thyroglobulin; thyroid cancer; WHOLE-BODY SCAN; HIGH SERUM THYROGLOBULIN; F-18 FDG PET/CT; TERM-FOLLOW-UP; ANTITHYROGLOBULIN ANTIBODY; CARCINOMA PATIENTS; TEST ACCURACY; RECURRENCE; PAPILLARY; F-18-FDG-PET;
D O I
10.1089/thy.2023.0264
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The objective of this study is to evaluate the diagnostic accuracy of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting recurrence in patients with differentiated thyroid cancer (DTC) who have negative whole-body scans (WBSs) but elevated serum thyroglobulin (Tg) or thyroglobulin antibody (TgAb) levels.Methods: This systematic review/meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Diagnostic Test Accuracy criteria (International Prospective Register of Systematic Reviews registration number: CRD42022340924). A comprehensive search of the MEDLINE, EMBASE, and Cochrane databases identified articles reporting the diagnostic accuracy of FDG PET/CT for the detection of recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels published between January 2012 and June 2023. Meta-analyses were performed to determine the diagnostic accuracy of FDG PET/CT on the total target population as well as on subgroups stratified by serum Tg or TgAb, and thyrotropin (TSH) stimulation status at the time of FDG PET/CT. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was applied to evaluate the quality of evidence and the strength of recommendations to facilitate translation of the meta-analysis results into practical recommendations for clinical guidelines.Results: A total of 24 studies involving 1988 patients were included for analysis. The overall pooled sensitivity and specificity values were 0.87 (95% confidence interval [CI] = 0.83-0.92; I-2 = 75%) and 0.84 (CI = 0.80-0.89; I-2 = 44%), respectively. Subgroup analyses revealed no significant differences in the diagnostic accuracy of FDG PET/CT in patients stratified by serum Tg or TgAb levels, and TSH stimulation status at the time of PET/CT. Treatment plans were changed following FDG PET/CT imaging in 40% (CI = 34-47%; I-2 = 39%) of cases. The quality level of evidence for using FDG PET/CT was moderate in both sensitivity and specificity according to the GRADE system.Conclusion: There is moderate quality evidence demonstrating the high diagnostic accuracy of FDG PET/CT in detecting recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels. This evidence corroborates the current guidelines' endorsement of FDG PET/CT as a diagnostic tool in such patients.
引用
收藏
页码:1224 / 1236
页数:13
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