In this systematic review and meta-analysis (PRISMA-compliant), we tried to investigate diagnostic and prognostic values of18F-FDG PET in uveal melanoma. A systematic search was conducted on the main medical literature databases to include studies that evaluated18F-FDG PET as the imaging modality to evaluate patients with uveal melanoma. Overall, 27 studies were included. Twelve had data about the detection rate of18F-FDG PET in primary intra-ocular tumours. The pooled sensitivity was 45% (95%CI: 41–50%). Furthermore, studies showed that the larger the primary tumour, the higher its uptake. Among the included studies, 13 assessed18F-FDG PET in detecting metastasis. The pooled sensitivity and specificity were 96% (95%CI: 81–99%) and 100% (95%CI: 94–100%), respectively. Regarding liver metastasis, they were 95% (95%CI: 79–99%) and 100% (95%CI: 91–100%), respectively. Noteworthy, the level of18F-FDG uptake was a strong predictor of patient survival. Lastly,18F-FDG PET could characterise lesions from the histopathology perspective, distinguishing high-risk from low-risk diseases. Overall, although not reliable in detecting primary intra-ocular tumours,18F-FDG PET is highly accurate for diagnosing metastatic uveal melanomas. It can also be a highly valuable modality in terms of patient prognostication. Thus,18F-FDG PET can be recommended in patients diagnosed with uveal melanoma to enhance decision-making and patient management.
在本项遵循PRISMA指南的系统综述与荟萃分析中，我们旨在探讨¹⁸F-FDG PET在葡萄膜黑色素瘤中的诊断与预后价值。通过系统检索主要医学文献数据库，纳入以¹⁸F-FDG PET作为影像学手段评估葡萄膜黑色素瘤患者的研究。共纳入27项研究，其中12项提供了¹⁸F-FDG PET对原发性眼内肿瘤检出率的数据，汇总敏感度为45%（95%CI：41-50%）。研究显示原发性肿瘤体积越大，其示踪剂摄取水平越高。在纳入的研究中，13项评估了¹⁸F-FDG PET检测转移灶的效能，汇总敏感度与特异度分别为96%（95%CI：81-99%）和100%（95%CI：94-100%）；针对肝转移灶的检测效能分别为95%（95%CI：79-99%）和100%（95%CI：91-100%）。值得注意的是，¹⁸F-FDG摄取水平是患者生存期的强预测因子。此外，¹⁸F-FDG PET能从组织病理学角度鉴别高风险与低风险病变。总体而言，尽管¹⁸F-FDG PET在检测原发性眼内肿瘤方面可靠性有限，但对转移性葡萄膜黑色素瘤的诊断具有高度准确性，在患者预后评估方面亦具有重要价值。因此，建议对确诊葡萄膜黑色素瘤的患者进行¹⁸F-FDG PET检查，以优化临床决策与患者管理。
肿瘤(癌症)患者之家