This review aims to compare the diagnostic performance of multidetector CT (MDCT), MRI, including diffusion-weighted imaging, and FDG PET/CT in the detection of peritoneal metastases (PMs) in ovarian cancer (OC). A comprehensive search was performed for articles published from 2000 to February 2023. The inclusion criteria were the following: diagnosis/suspicion of PMs in patients with ovarian/fallopian/primary peritoneal cancer; initial staging or suspicion of recurrence; MDCT, MRI and/or FDG PET/CT performed for the detection of PMs; population of at least 10 patients; surgical results, histopathologic analysis, and/or radiologic follow-up, used as reference standard; and per-patient and per-region data and data for calculating sensitivity and specificity reported. In total, 33 studies were assessed, including 487 women with OC and PMs. On a per-patient basis, MRI (p= 0.03) and FDG PET/CT (p< 0.01) had higher sensitivity compared to MDCT. MRI and PET/CT had comparable sensitivities (p= 0.84). On a per-lesion analysis, no differences in sensitivity estimates were noted between MDCT and MRI (p= 0.25), MDCT and FDG PET/CT (p= 0.68), and MRI and FDG PET/CT (p= 0.35). Based on our results, FDG PET/CT and MRI are the preferred imaging modalities for the detection of PMs in OC. However, the value of FDG PET/CT and MRI compared to MDCT needs to be determined. Future research to address the limitations of the existing studies and the need for standardization and to explore the cost-effectiveness of the three imaging modalities is required.
本综述旨在比较多层螺旋CT（MDCT）、磁共振成像（包括弥散加权成像）以及氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）在检测卵巢癌腹膜转移中的诊断效能。我们对2000年至2023年2月期间发表的相关文献进行了全面检索。纳入标准如下：研究对象为卵巢/输卵管/原发性腹膜癌患者，需确诊或疑似腹膜转移；涉及初始分期或疑似复发；采用MDCT、MRI和/或FDG PET/CT检测腹膜转移；研究人群不少于10例患者；以手术结果、组织病理学分析和/或影像学随访作为参考标准；并报告了基于患者层面和区域层面的数据，以及用于计算敏感性和特异性的数据。共纳入33项研究，涵盖487例卵巢癌伴腹膜转移的女性患者。基于患者层面的分析显示，与MDCT相比，MRI（p=0.03）和FDG PET/CT（p<0.01）具有更高的敏感性。MRI与PET/CT的敏感性相当（p=0.84）。在基于病灶层面的分析中，MDCT与MRI（p=0.25）、MDCT与FDG PET/CT（p=0.68）以及MRI与FDG PET/CT（p=0.35）之间的敏感性估计值均无显著差异。根据本研究结果，FDG PET/CT和MRI是检测卵巢癌腹膜转移的首选影像学方法。然而，FDG PET/CT和MRI相较于MDCT的价值仍需进一步明确。未来研究需解决现有研究的局限性、推动标准化进程，并探讨三种影像学方法的成本效益。
肿瘤(癌症)患者之家