Colorectal liver metastases: CT, MR imaging, and PET for diagnosis - Meta-analysis

被引:369
作者
Bipat, S
van Leeuwen, MS
Comans, EFI
Pijl, MEJ
Bossuyt, PMM
Zwinderman, AH
Stoker, J
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Epidemiol & Biostat, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Utrecht, Med Ctr, Dept Radiol, Utrecht, Netherlands
[4] Vrije Univ Amsterdam, Dept Nucl Med, NL-1081 HV Amsterdam, Netherlands
[5] Vrije Univ Amsterdam, PET Res, NL-1081 HV Amsterdam, Netherlands
[6] Martini Hosp, Dept Radiol, Groningen, Netherlands
关键词
D O I
10.1148/radiol.2371042060
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To perform a meta-analysis to obtain sensitivity estimates of computed tomography (CT), magnetic resonance (MR) imaging and fluorine 18 fluorodeoxy- , glucose (FDG) positron emission tomography (PET) for detection of colorectal liver metastases on per-patient and per-lesion bases. MATERIALS AND METHODS: MEDLINE, EMBASE, Web of Science and CANCERLIT, databases and Cochrane Database of Systematic Reviews were searched for including original articles published from January 1990 to December 2003. Criteria for inclusion of articles were as follows: Articles were reported in the English German or,, French language; CT, MR imaging, or FDG PET was performed to identify and characterize colorectal liver metastases; histopathologic analysis (surgery, biopsy, or autopsy), intraoperative observation (manual palpatation, intraoperative ultrasonography [US]), and/or follow-up US was the reference standard; and data were sufficient for calculation of true-positive or false-negative values. A random-effects linear regression model was used to obtain sensitivity estimates in assessment of liver metastases. RESULTS: Of 165 identified relevant articles, 61 fulfilled all inclusion criteria Sen. sitivity estimates on a per-patient basis for nonhelical CT, helical CT, 1.5-T MR imaging, and FDG PET were 60.2%, 64.7%, 75.8%, and 94.6%, respectively; FDG PET was the most accurate modality. On a per-lesion basis, sensitivity estimates for nonhelical CT, helical CT, 1.0-T MR imaging, 1.5-T MR imaging, and FDG PET were 52.3%, 63.8%, 66.1%, 64.4%, and 75.9%, respectively; nonhelical CT had lowest sensitivity. Estimates of gadolinium-enhanced MR imaging and superparamagnetic iron oxide (SPIO)-enhanced MR imaging were significantly better, compared with nonenhanced MR imaging (P =.019 and P <.001, respectively) and with helical CT with 45 g of iodine or less (P =.02 and P <.001, respectively). For lesions of I cm or larger, SPIO-enhanced MR imaging was the most accurate modality (P <.001). CONCLUSION: FDG PET had significantly higher sensitivity on a per-patient basis, compared with that of the other modalities, but not on a per-lesion basis. Sensitivity estimates for MR imaging with contrast agent were significantly superior to those for helical CT with 45 g of iodine or less. (c) RSNA, 2005.
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页码:123 / 131
页数:9
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