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FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis.

Pan L, Han Y, Sun X, Liu J, Gang H - J. Cancer Res. Clin. Oncol. (2010)

Bottom Line: No statistical significance was found between MRI and PET.There was heterogeneity among studies and evidence of publication bias.In conclusion, MRI seemed to be a more useful supplement to current surveillance techniques to assess patients with suspected recurrent and/or metastatic breast cancer.

View Article: PubMed Central - PubMed

Affiliation: Chinese Academy of Sciences, 730000 Lanzhou, China.

ABSTRACT

Background and purpose: Breast carcinoma is the most common cancer in female patients with a propensity for recurrence and metastases. The accuracy of ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), scintimammography (SMM) and positron emission tomography (PET) in diagnosing the recurrent and/or breast cancer has never been systematically assessed, and present systematic review was aimed at this issue.

Methods: MEDLINE and EMBASE were searched for articles dealt with detection of recurrent and/or metastatic breast cancer by US, CT, MRI, SMM or PET whether interpreted with or without the use of CT. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference. We extracted data to calculate sensitivity, specificity, summary receiver operating characteristic curves and area under the curve and to test for heterogeneity.

Result: In 42 included studies, US and MRI had highest pooled specificity (0.962 and 0.929, respectively); MRI and PET had highest pooled sensitivity (0.9500 and 0.9530, respectively). The AUC of US, CT, MRI, SMM and PET was 0.9251, 0.8596, 0.9718, 0.9386 and 0.9604, respectively. Results of pairwise comparison between each modality demonstrated that AUC of MRI and PET was higher than that of US or CT, p < 0.05. No statistical significance was found between MRI and PET. There was heterogeneity among studies and evidence of publication bias.

Conclusion: In conclusion, MRI seemed to be a more useful supplement to current surveillance techniques to assess patients with suspected recurrent and/or metastatic breast cancer. If MRI shows an indeterminate or benign lesion or MRI was not applicable, FDG-PET could be performed in addition.

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Summary ROC curves of US, CT, MRI, SMM and PET
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Fig2: Summary ROC curves of US, CT, MRI, SMM and PET

Mentions: Summary receiver operating characteristic analysis was used to compare those non-invasive modalities. The AUC of US, CT, MRI, SMM and PET (with or without CT) was presented in Table 8. AUC of MRI and PET (with or without CT) is 0.9718 and 0.9604, respectively; however, no significant difference was found between those two modalities, p > 0.05. Results of pairwise comparison between each modality demonstrated that AUC of both MRI and PET (with or without CT) was higher than that of US or CT, p < 0.05. AUC of SMM was 0.9386, no statistical significance was found when compared with that of MRI and PET (with or without CT), p > 0.05. In terms of its AUC, there was still no statistical significance between CT and US, p > 0.05. The Q* index estimates for US, CT, MRI, SMM and PET (with or without CT) were 0.8593, 0.7904, 0.9228, 0.8757 and 0.9051, respectively. Like AUC, the Q* index estimates for MRI and PET were significantly higher than for US, CT and SMM, p < 0.05. And, they were similar for MRI and PET (Table 9; Fig 2).Fig. 2


FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis.

Pan L, Han Y, Sun X, Liu J, Gang H - J. Cancer Res. Clin. Oncol. (2010)

Summary ROC curves of US, CT, MRI, SMM and PET
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2874488&req=5

Fig2: Summary ROC curves of US, CT, MRI, SMM and PET
Mentions: Summary receiver operating characteristic analysis was used to compare those non-invasive modalities. The AUC of US, CT, MRI, SMM and PET (with or without CT) was presented in Table 8. AUC of MRI and PET (with or without CT) is 0.9718 and 0.9604, respectively; however, no significant difference was found between those two modalities, p > 0.05. Results of pairwise comparison between each modality demonstrated that AUC of both MRI and PET (with or without CT) was higher than that of US or CT, p < 0.05. AUC of SMM was 0.9386, no statistical significance was found when compared with that of MRI and PET (with or without CT), p > 0.05. In terms of its AUC, there was still no statistical significance between CT and US, p > 0.05. The Q* index estimates for US, CT, MRI, SMM and PET (with or without CT) were 0.8593, 0.7904, 0.9228, 0.8757 and 0.9051, respectively. Like AUC, the Q* index estimates for MRI and PET were significantly higher than for US, CT and SMM, p < 0.05. And, they were similar for MRI and PET (Table 9; Fig 2).Fig. 2

Bottom Line: No statistical significance was found between MRI and PET.There was heterogeneity among studies and evidence of publication bias.In conclusion, MRI seemed to be a more useful supplement to current surveillance techniques to assess patients with suspected recurrent and/or metastatic breast cancer.

View Article: PubMed Central - PubMed

Affiliation: Chinese Academy of Sciences, 730000 Lanzhou, China.

ABSTRACT

Background and purpose: Breast carcinoma is the most common cancer in female patients with a propensity for recurrence and metastases. The accuracy of ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), scintimammography (SMM) and positron emission tomography (PET) in diagnosing the recurrent and/or breast cancer has never been systematically assessed, and present systematic review was aimed at this issue.

Methods: MEDLINE and EMBASE were searched for articles dealt with detection of recurrent and/or metastatic breast cancer by US, CT, MRI, SMM or PET whether interpreted with or without the use of CT. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference. We extracted data to calculate sensitivity, specificity, summary receiver operating characteristic curves and area under the curve and to test for heterogeneity.

Result: In 42 included studies, US and MRI had highest pooled specificity (0.962 and 0.929, respectively); MRI and PET had highest pooled sensitivity (0.9500 and 0.9530, respectively). The AUC of US, CT, MRI, SMM and PET was 0.9251, 0.8596, 0.9718, 0.9386 and 0.9604, respectively. Results of pairwise comparison between each modality demonstrated that AUC of MRI and PET was higher than that of US or CT, p < 0.05. No statistical significance was found between MRI and PET. There was heterogeneity among studies and evidence of publication bias.

Conclusion: In conclusion, MRI seemed to be a more useful supplement to current surveillance techniques to assess patients with suspected recurrent and/or metastatic breast cancer. If MRI shows an indeterminate or benign lesion or MRI was not applicable, FDG-PET could be performed in addition.

Show MeSH
Related in: MedlinePlus