Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Cancer Research Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran; Evidence-Based Medicine Study Center, Hormozgan University of Medical Sciences, Bandar Abass, Iran.
Eur J Radiol. 2023 Oct;167:111051. doi: 10.1016/j.ejrad.2023.111051. Epub 2023 Aug 16.
Magnetic resonance imaging (MRI) can reduce the need for unnecessary invasive diagnostic tests by nearly half. In this meta-analysis, we investigated the diagnostic accuracy of intravoxel incoherent motion modeling (IVIM) and dynamic contrast-enhanced (DCE) MRI in differentiating benign from malignant breast lesions.
We systematically searched PubMed, EMBASE, and Scopus. We included English articles reporting diagnostic accuracy for both sequences in differentiating benign from malignant breast lesions. Articles were assessed by quality assessment of diagnostic accuracy studies-2 (QUADAS-2) questionnaire. We used a bivariate effects model for standardized mean difference (SMD) analysis and diagnostic test accuracy analysis.
Ten studies with 537 patients and 707 (435 malignant and 272 benign) lesions were included. The D, f, Ktrans, and Kep mean values significantly differ between benign and malignant lesions. The pooled sensitivity (95 % confidence interval) and specificity were 86.2 % (77.9 %-91.7 %) and 70.3 % (56.5 %-81.1 %) for IVIM, and 93.8 % (85.3 %-97.5 %) and 68.1 % (52.7 %-80.4 %) for DCE, respectively. Combined IVIM and DCE depicted the highest area under the curve of 0.94, with a sensitivity and specificity of 91.8 % (82.8 %-96.3 %) and 87.6 % (73.8 %-94.7 %), respectively.
Combined IVIM and DCE had the highest diagnostic accuracy, and multiparametric MRI may help reduce unnecessary benign breast biopsy.
磁共振成像（MRI）可将不必要的有创诊断性检查减少近一半。在这项荟萃分析中，我们研究了体素内不相干运动建模（IVIM）和动态对比增强（DCE）MRI 在鉴别良恶性乳腺病变中的诊断准确性。
我们系统地检索了 PubMed、EMBASE 和 Scopus。我们纳入了报告两种序列在鉴别良恶性乳腺病变中的诊断准确性的英文文章。文章采用诊断准确性研究质量评估-2（QUADAS-2）问卷进行评估。我们使用双变量效应模型进行标准化均数差（SMD）分析和诊断试验准确性分析。
纳入了 10 项研究，共 537 例患者和 707 个（435 个恶性和 272 个良性）病灶。良性和恶性病变之间的 D、f、Ktrans 和 Kep 值存在显著差异。IVIM 的汇总敏感性（95%置信区间）和特异性分别为 86.2%（77.9%-91.7%）和 70.3%（56.5%-81.1%），DCE 的分别为 93.8%（85.3%-97.5%）和 68.1%（52.7%-80.4%）。IVIM 和 DCE 联合显示出最高的曲线下面积为 0.94，其敏感性和特异性分别为 91.8%（82.8%-96.3%）和 87.6%（73.8%-94.7%）。
IVIM 和 DCE 联合具有最高的诊断准确性，多参数 MRI 可能有助于减少不必要的良性乳腺活检。
