Document Type: Systematic Review/Meta-analysis
Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
International Campus, Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Physics, College of Natural Sciences, Aksum University, Aksum, Ethiopia
Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
PET/CT and Cyclotron Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Public Health, College of Medical and Health Sciences, Ambo University, Ambo, Ethiopia
Department of Physics, Faculty of Natural Sciences, Debre Tabor University, Debre Tabor, Ethiopia
Department of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
Introduction:The accuracy of positron emission tomography with computed tomography (PET/CT), positron emission mammography (PEM), and breast specific-gamma imaging (BSGI) in diagnosing breast cancer has never been systematically assessed, the present systematic review was aimed to address this issue.
Methods:PubMed, Scopus and EMBASE were searched for studies dealt with the detection of breast cancer by PET/CT, PEM or BSGI. Histopathologic examination and/or at least six months imaging follow-up were used as a golden reference. To calculate diagnostic test parameters: sensitivity, specificity, summary receiver operating characteristic curves (SROC) and to test for heterogeneity, true positive (TP), true negative (TN), false positive (FP) and false negative (FN) were extracted.
Results: Thirty one studies were included in the analysis. On per-patient basis, the pooled sensitivities after corrected for threshold effect for 18F-FDG PET/CT, PEM, and 99mTc-MIBI BSGI were 0.89 (95% CI: 0.78- 0.95), 0.73 (95% CI: 0.41 - 0.92), and 0.80 (95% CI: 0.72 - 0.86) respectively. The pooled specificities for detection of breast cancer using FDG PET/CT, PEM, and 99mTc-MIBI BSGI were 0.93 (95 % CI, 0.86 - 0.96), 0.91 (95 % CI, 0.77- 96), and 0.78 (95 % CI, 0.64 - 0.88), respectively. AUC of FDG PET/CT, PEM, and BSGI were 0.9549, 0.8852 and 0.8573, respectively.
Conclusion: This meta-analysis indicated that PET/CT showed better diagnostic accuracy than PEM, and BSGI on per-patient basis. On per-lesion analysis, PEM with the highest AUC, DOR and Q* was better than PET/CT, and BSGI for detecting breast cancer.