Abstract
Introduction
By performing a systematic review and meta-analysis, the diagnostic value of 18F-FDG PET/MRI in breast lesions, lymph nodes, and distant metastases was assessed,
and the merits and demerits of PET/MRI in the application of breast cancer were comprehensively
reviewed.
Methods
Breast cancer-related studies using 18F-FDG PET/MRI as a diagnostic tool published before September 12, 2022 were included.
The pooled sensitivity, specificity, log diagnostic odds ratio (LDOR), and area under
the curve (AUC) were calculated using Bayesian bivariate meta-analysis in a lesion-based
and patient-based manner.
Results
We ultimately included 24 studies (including 1723 patients). Whether on a lesion-based
or patient-based analysis, PET/MRI showed superior overall pooled sensitivity (0.95
[95% CI: 0.92-0.98] & 0.93 [95% CI: 0.88-0.98]), specificity (0.94 [95% CI: 0.90-0.97]
& 0.94 [95% CI: 0.92-0.97]), LDOR (5.79 [95% CI: 4.95-6.86] & 5.64 [95% CI: 4.58-7.03])
and AUC (0.98 [95% CI: 0.94-0.99] & 0.98[95% CI: 0.92-0.99]) for diagnostic applications
in breast cancer. In the specific subgroup analysis, PET/MRI had high pooled sensitivity
and specificity for the diagnosis of breast lesions and distant metastatic lesions
and was especially excellent for bone lesions. PET/MRI performed poorly for diagnosing
axillary lymph nodes but was better than for lymph nodes at other sites (pooled sensitivity,
specificity, LDOR, AUC: 0.86 vs. 0.58, 0.90 vs. 0.82, 4.09 vs. 1.98, 0.89 vs. 0.84).
Conclusion
18F-FDG PET/MRI performed excellently in diagnosing breast lesions and distant metastases.
It can be applied to the initial diagnosis of suspicious breast lesions, accurate
staging of breast cancer patients, and accurate restaging of patients with suspected
recurrence.
Keywords
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Article info
Publication history
Published online: November 30, 2022
Accepted:
November 26,
2022
Received in revised form:
November 7,
2022
Received:
April 26,
2022
Identification
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