Abstract
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Objectives The aim of this study was to perform a comprehensive meta-analysis comparing the diagnostic performance of choline-PET/CT, MRI, SPECT and bone scintigraphy in detecting bone metastases in parents with prostate cancer.
Methods The PubMed, EBSCO, EMBASE, Web of Knowledge, Ovid and the Cochrane Library were searched for relevant articles published. Pooled sensitivity, specificity and diagnostic odds ratios (DOR) were calculated both on a per-patient basis and on a per-lesion basis with a software program called Meta-DiSc. Summary receiver operating characteristic (SROC) curves were also drawn to obtain the area under curve (AUC) and Q* value. Furthermore, a subgroup analysis about BS was also performed.
Results Sixteen articles consisting of 27 studies were included in the analysis. The detailed results were shown in the Table. On a per-patient basis, the pooled sensitivity by using PET/CT, MRI and BS were 0.91, 0.97 and 0.79, respectively. The pooled specificity were 0.99, 0.95 and 0.82, respectively. On a per-lesion basis, the pooled sensitivity of PET/CT, SPECT, BS were 0.84, 0.90 and 0.59, respectively. The pooled specificity were 0.93 for PET/CT, 0.85 for SPECT, 0.75 for BS. On the basis of subgroup analysis of BS, the sensitivity, specificity and DOR of prospective design studies were better than those of retrospective design studies.
Conclusions MRI was found to be better than PET/CT and BS on a per-patient basis. On a per-lesion analysis, PET/CT with the highest DOR and Q* was better than SPECT and BS for detecting bone metastases from prostate cancer. Among these modalities, BS had the lowest sensitivity and specificity while it is lowest in price.