Zhang Xin, Liu Yuanyuan, Luo Hongbing, Zhang Jianhui
Department of Breast Surgery, Sichuan Cancer Hospital and Research Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China.
Division of Radiology, Sichuan Cancer Hospital and Research Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu, China.
J Magn Reson Imaging. 2020 Dec;52(6):1840-1851. doi: 10.1002/jmri.27246. Epub 2020 Jun 21.
Axillary lymph node metastases (ALNM) is one of the most important prognostic factors in breast cancer. Positron emission tomography / computed tomography (PET/CT) and magnetic resonance imaging (MRI) are increasingly used to assess ALNM noninvasively. There has been no study investigating PET/CT and MRI in direct comparative studies.
To assess the diagnostic accuracy of PET/CT and MRI for ALNM in the same population of breast cancer.
Systematic review and meta-analysis.
PubMed-MEDLINE, Web of Science, Cochrane, EMBASE, and Chinese Biomedical Literature databases were searched (September 1993-January 2020) by using concerned keywords. Studies using both MRI and PET/CT as diagnostic methods were included. Eleven studies included 1203 breast cancer patients using PET/CT and 1186 patients using MRI.
1.5T or 3.0T.
The Quality Assessment of Diagnostic Accuracy Studies (v. 2) was used to assess the quality of the studies.
A bivariate mixed-effects binary regression model was used to obtain the diagnostic performance. Meta-regression analysis was conducted to investigate study heterogeneity.
A total of 369 articles were screened; out of these, 11 studies were included that meet the inclusion criteria. The respective pooled sensitivity and specificity values were 0.56 (95% confidence interval [CI]: 0.47-0.63) and 0.91 (95% CI: 0.87-0.93) for PET/CT and 0.55 (95% CI: 0.48-0.62) and 0.86 (95% CI: 0.82-0.89) for MRI. There was no statistically significant difference in sensitivity (P = 0.769) or specificity (P = 0.447) between PET/CT and MRI. There was no threshold effect in either of the imaging tests. The diagnostic performance of both imaging tests was affected by study design, breast cancer subtype, tumor stage, or imaging features.
In the same population, PET/CT and MRI had comparable diagnostic performance for the detection of ALNM, with low sensitivity and high specificity.
Stage 2. J. MAGN. RESON. IMAGING 2020;52:1840-1851.
腋窝淋巴结转移（ALNM）是乳腺癌最重要的预后因素之一。正电子发射断层扫描/计算机断层扫描（PET/CT）和磁共振成像（MRI）越来越多地用于无创评估ALNM。尚无研究在直接比较研究中对PET/CT和MRI进行调查。
评估PET/CT和MRI在同一乳腺癌人群中对ALNM的诊断准确性。
系统评价和荟萃分析。
通过使用相关关键词检索PubMed-MEDLINE、科学网、Cochrane、EMBASE和中国生物医学文献数据库（1993年9月至2020年1月）。纳入使用MRI和PET/CT作为诊断方法的研究。11项研究包括1203例使用PET/CT的乳腺癌患者和1186例使用MRI的患者。
1.5T或3.0T。
使用诊断准确性研究质量评估（第2版）来评估研究质量。
使用双变量混合效应二元回归模型获得诊断性能。进行荟萃回归分析以研究研究异质性。
共筛选出369篇文章；其中，11项研究符合纳入标准。PET/CT的合并敏感性和特异性值分别为0.56（95%置信区间[CI]：0.47-0.63）和0.91（95%CI：0.87-0.93），MRI的合并敏感性和特异性值分别为0.55（95%CI：0.48-0.62）和0.86（95%CI：0.82-0.89）。PET/CT和MRI在敏感性（P = 0.769）或特异性（P = 0.447）方面无统计学显著差异。两种成像检查均无阈值效应。两种成像检查的诊断性能均受研究设计、乳腺癌亚型、肿瘤分期或成像特征的影响。
在同一人群中,PET/CT和MRI对ALNM的检测具有相当的诊断性能，敏感性低，特异性高。
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2期。J.MAGN.RESON.IMAGING 2020;52:1840-1851。
