Performance of bone tracer for diagnosis and differentiation of transthyretin cardiac amyloidosis: a systematic review and meta-analysis
| Autor: | Hongliang Zhao, Wei Cui, Haijuan Hu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty biology Receiver operating characteristic business.industry MEDLINE Heart Amyloidosis Cochrane Library Confidence interval Bone and Bones Nuclear Medicine and Molecular Imaging Transthyretin Cardiac amyloidosis Meta-analysis Internal medicine biology.protein Diagnostic odds ratio Medicine Humans Prealbumin business Radionuclide Imaging |
| Zdroj: | Diagn Interv Radiol |
| Popis: | PURPOSE: Bone tracers have been validated for many years in detecting transthyretin cardiac amyloidosis (TTR-CA). However, several new studies suggest conflicting results. Our study aimed to systematically evaluate the accuracy of bone radiotracers for diagnosis and differentiation of TTR-CA via a systematic review and meta-analysis. METHODS: We retrieved articles assessing the performance of bone tracer in diagnosing and differentiating TTR-CA from PubMed, the Cochrane Library, ScienceDirect, and DOAJ databases, dating up to 10 July 2020. The meta-analysis was conducted through Stata 16 software, and the risk of bias for the included studies was assessed by the QUADAS-2 tool. Moreover, we made a comprehensive review. RESULTS: Fourteen articles were included in the systematic review, and 9 in the meta-analysis. The pooled sensitivity was 0.97 (95% confidence interval [95% CI] 0.85–0.99) with heterogeneity (I(2)=73.5, 95% CI 55.6–91.2), and the specificity was 0.92 (95% CI 0.82–0.96) with heterogeneity (I(2)=42.0, 95% CI 0.0–86.9). The pooled positive and negative likelihood ratios were 11.49 (95% CI 5.07–26.0) and 0.03 (95% CI 0.01–0.18), respectively. The diagnostic odds ratio was 341 (95% CI 53–2194), and the area under the receiver operating characteristic curve was 0.96 (95% CI 0.94–0.97). CONCLUSION: The findings evidence that the bone radiotracer is a valuable noninvasive approach that provides high accuracy for diagnosing TTR-CA and plays a modest role in differentiating TTR-CA from immunoglobulin amyloid light-chain cardiac amyloidosis. (99m)Tc-HMDP may be more accurate than (99m)Tc-PYP, (99m)Tc-DPD, and (18)F-NaF in the TTR-CA detecting process, and (18)F-NaF is a promising bone tracer to diagnose and differentiate TTR-CA. |
| Databáze: | OpenAIRE |
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