We described the diagnostic performance of [18F]F-FDG-PET in malignant melanoma by conducting a comprehensive systematic review and meta-analysis of the existing literature. The study was designed following PRISMA-DTA. Original articles with adequate crude data for meta-analytic calculations that evaluated [18F]F-FDG-PET and compared it with a valid reference standard were considered eligible. The pooled measurements were calculated based on the data level (patient/lesion-based). Regarding sub-groups, diagnostic performances were calculated for local, regional and distant involvement. The bivariate model was employed to calculate sensitivity and specificity. The initial search resulted in 6678 studies. Finally, 100 entered the meta-analysis, containing 82 patient-based (10,403 patients) and 32 lesion-based (6188 lesions) datasets. At patient level, overall, [18F]F-FDG-PET had pooled sensitivity and specificity of 81% (95%CI: 73–87%) and 92% (95%CI: 90–94%), respectively. To detect regional lymph node metastasis, the pooled sensitivity and specificity were 56% (95%CI: 40–72%) and 97% (95%CI: 94–99%), respectively. To detect distant metastasis, they were 88% (95%CI: 81–93%) and 94% (95%CI: 91–96%), respectively. At lesion level, [18F]F-FDG-PET had a pooled sensitivity and specificity of 70% (95%CI: 57–80%) and 94% (95%CI: 88–97%), respectively. Thus, [18F]F-FDG-PET is a valuable diagnostic modality for melanoma assessment. It was accurate in various clinical scenarios. However, despite its high specificity, it showed low sensitivity in detecting regional lymph node metastasis and could not replace lymph node biopsy.
本研究通过对现有文献进行系统性综述与荟萃分析，评估了[18F]F-FDG-PET在恶性黑色素瘤中的诊断效能。研究设计遵循PRISMA-DTA指南。纳入标准为包含可用于荟萃分析的原始数据、评估[18F]F-FDG-PET并与有效金标准进行比较的原始研究。汇总测量值根据数据层级（基于患者/病灶）进行计算。在亚组分析中，分别计算了局部、区域及远处转移的诊断效能。采用双变量模型计算敏感性与特异性。 初步检索获得6678项研究，最终100项研究纳入荟萃分析，包含82项基于患者的数据集（10,403例患者）和32项基于病灶的数据集（6188个病灶）。在患者层面，[18F]F-FDG-PET的总体汇总敏感性与特异性分别为81%（95%CI：73–87%）和92%（95%CI：90–94%）。针对区域淋巴结转移检测，汇总敏感性与特异性分别为56%（95%CI：40–72%）和97%（95%CI：94–99%）；针对远处转移检测，分别为88%（95%CI：81–93%）和94%（95%CI：91–96%）。在病灶层面，汇总敏感性与特异性分别为70%（95%CI：57–80%）和94%（95%CI：88–97%）。 研究表明，[18F]F-FDG-PET是黑色素瘤评估的重要诊断手段，在不同临床场景中均表现出良好准确性。然而，尽管其特异性较高，但在检测区域淋巴结转移时敏感性较低，尚不能替代淋巴结活检。
肿瘤(癌症)患者之家