Diagnostic Performance Of PET/CT In DTC Patients With Negative Iodine Scisntigraphy:A Meta-analysis

Objective:To explore whether 18F-FDG PET/CT can help in clinical diagnosis and treatment of DTC patients with negative 131I-WBS imaging after surgery,and to use meta-analysis to evaluate the application value of PET/CT in diagnosing recurrence or metastasis in DTC patients with negative 131I-WBS imaging.Methods:Chinese and English databases such as Wanfang database,VIP literature database,CNKI,CBM,Cochrane Library database,Embase,PubMed,and Web of Science were searched for all the literatures related to the diagnostic value of PET/CT in DTC patients with negative 131I-WBS imaging before January 2021.According to the literature inclusion and exclusion criteria,two examiners screen the literature strictly according to the criteria,extract information from the documents that meet the requirements.The quality of the included literature was evaluated by ReviewManager5.3 software according to QUADAS-2 tool,and the heterogeneity test and sensitivity analysis were carried out by MetaDiSc software.According to the results of heterogeneity,random effect model or fixed effect model was used to combine Sen,Spec,PLR,NLR and DOR,and forest map and sROC curve were drawn to calculate AUC value.Statal6.0 software was used for statistical analysis.Results:The 35 literature studies finally included in this meta-analysis(a total of 1901 patients,aged 9-88 years)are eligible for further research.The random effects model was used to combine the diagnostic performance statistics of PET/CT.The values of Sen,Spec,PLR,NLR,DOR and AUC were 0.86(95%CIs:0.82-0.90),0.80(95%CIs:0.70-0.87),respectively.4.2(95%CIs:2.8-6.4),0.17(95%CIs:0.13-0.24),24(95%CIs:12-47),0.90(95%CIs:0.87-0.93).The I2 of Sen and Spec were 74.30%(95%CIs:65.83-82.77)and 79.8g%(95%CIs:73.70-86.09),respectively,indicating that the included studies have high heterogeneity.The subgroup analysis of this study showed that the study type(P=0.01),the number of patients(P=0.01),TSH stimulation(P=0.04),race(P=0.01),the proportion of FTC(P=0.01),The proportion of males(P=0.02)may be the source of heterogeneity.Sensitivity analysis found that:5 original studies have strong sensitivity,and other original studies will not cause sensitivity to the calculation results.Deeks published a bias test suggesting that this study may be biased(P=0.01).Conclusion:18F-FDG PET/CT in DTC patients with negative 131i-WBS imaging after surgery,the detection of recurrence or metastatic lesions has high diagnostic accuracy,but the existing research results are affected by high heterogeneity and publication bias.