Department of Artificial Intelligence, Universidad Nacional de Educación a Distancia (UNED), Juan del Rosal, 16, Madrid, 28040, Spain.
Syst Rev. 2024 Nov 28;13(1):295. doi: 10.1186/s13643-024-02708-9.
Breast thermography originated in the 1950s but was later abandoned due to the contradictory results obtained in the following decades. However, advances in infrared technology and image processing algorithms in the twenty-first century led to a renewed interest in thermography. This work aims to provide an updated and objective picture of the recent scientific evidence on its effectiveness, both as a screening and as a diagnostic tool.
We searched for clinical studies published between 2001 and May 31, 2023, in the databases PubMed and Scopus, that aimed to evaluate the effectiveness of digital, long-wave infrared imaging for detecting breast cancer. Additional documents were retrieved from the studies included in the systematic reviews that resulted from the search and by searching for the names of commercial systems. We limited our selection to studies that reported the sensitivity and specificity of breast thermography (or the data needed to calculate them) using images collected by themselves, with at least five breast cancer cases. Studies that considered breast diseases other than cancer to be positive or that did not use standard tests to set the ground truth diagnosis were excluded, as well as articles written in a language other than English and documents we could not access. We also conducted meta-analyses of proportions of the sensitivity and specificity values reported in the selected studies and a bivariate meta-analysis to account for the correlation between these metrics.
Our systematic search resulted in 22 studies, with an average pooled sensitivity and specificity of 88.5% and 71.8%, respectively. However, the differences in patient recruitment, sample size, imaging protocol, equipment, and interpretation criteria yielded a high heterogeneity measure (79.3% and 99.1% value, respectively).
Overall, thermography showed a high sensitivity in the selected studies, whereas specificity started off lower and increased over time. The most recent studies reported a combination of sensitivity and specificity comparable to standard diagnostic tests. Most of the selected studies were small and tend to include only patients with a suspicious mass that requires biopsy. However, larger studies with a wider variety of patient types (asymptomatic, women with dense breasts, etc.) have been published in the latest years.
乳房热成像技术起源于 20 世纪 50 年代，但在随后的几十年里，由于得出的结果相互矛盾，该技术被弃用。然而，21 世纪红外技术和图像处理算法的进步重新引起了人们对热成像的兴趣。本工作旨在提供乳房热成像技术近期作为筛查和诊断工具的有效性的最新、客观的科学证据。
我们在 PubMed 和 Scopus 数据库中搜索了 2001 年至 2023 年 5 月 31 日期间发表的临床研究，这些研究旨在评估数字、长波红外成像检测乳腺癌的有效性。从系统评价中包含的研究中检索到了额外的文件，并通过搜索商业系统的名称进行检索。我们将选择范围限制在那些使用自己收集的图像报告了乳房热成像的敏感性和特异性（或需要计算这些值的数据）的研究，并且至少有 5 例乳腺癌病例。排除了将除癌症以外的乳房疾病视为阳性的研究，以及未使用标准测试确定真实诊断的研究，以及用其他语言撰写的文章和我们无法获取的文件。我们还对所选研究报告的敏感性和特异性值的比例进行了荟萃分析，并进行了二元荟萃分析，以解释这些指标之间的相关性。
我们的系统搜索共得到 22 项研究，平均合并敏感性和特异性分别为 88.5%和 71.8%。然而，患者招募、样本量、成像方案、设备和解释标准的差异导致了高度的异质性测量（分别为 79.3%和 99.1% 值）。
总体而言，热成像在所选研究中表现出较高的敏感性，而特异性则较低，并随着时间的推移而增加。最近的研究报告了敏感性和特异性的组合与标准诊断测试相当。大多数选定的研究规模较小，往往只包括需要活检的可疑肿块的患者。然而，近年来发表了更多的大型研究，涵盖了更广泛的患者类型（无症状、乳房致密的女性等）。
