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Comparing the diagnostic efficacy of [18F]FDG PET/CT and [18F]FDG PET/MRI for detecting bone metastases in breast cancer: a meta-analysis

Longjie Xia
Longjie Xia
, 
Jianqin Lai
Jianqin Lai
, 
Di Huang
Di Huang
, 
Shenghui Qiu
Shenghui Qiu
, 
Huiqiong Hu
Huiqiong Hu
, 
Yunxiang Luo
Yunxiang Luo
 y 
Jie Cao
Jie Cao
   | 26 jul 2023
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Article Category: Research Article
Publicado en línea: 26 jul 2023
Páginas: 299 - 309
Recibido: 01 abr 2023
Aceptado: 15 jun 2023
DOI: https://doi.org/10.2478/raon-2023-0037
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© 2023 Longjie Xia et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

PRISMA flow diagram illustrating the study selection process.FN = false negative; FP = false positive; TN = true negative; TP = true positive
PRISMA flow diagram illustrating the study selection process.FN = false negative; FP = false positive; TN = true negative; TP = true positive

FIGURE 2.

Risk of bias and applicability concerns of the included studies using the Quality Assessment of Diagnostic Performance Studies QUADAS-2 tool.
Risk of bias and applicability concerns of the included studies using the Quality Assessment of Diagnostic Performance Studies QUADAS-2 tool.

FIGURE 3.

Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25
Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25

FIGURE 4.

Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,10,11,18,19,20,22,23,24,25,26,27
Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,10,11,18,19,20,22,23,24,25,26,27

FIGURE 5.

Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25
Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25

FIGURE 6.

Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,18,19,20,21,23,25,26,27
Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,18,19,20,21,23,25,26,27

Study and patient characteristics of the included studies for [18F]FDG PET/CT

Author Year Type of imaging test Study characteristics Patient characteristics
Country Study design Analysis Reference standard No. of patients Clinical indication Mean/Median age Previous treatment
Catalano et al.15 2015 PET/CT Italy Retro PB Pathology and/or follow-up imaging 109 Initial stage and post-treatment stage Mean ± SD: (58.08 ± 10.7) Surgery
Melsaether et al.10 2016 PET/CT USA Pro LB Pathology and/or follow-up imaging 51 Initial stage and post-treatment stage Mean(range): 56 (32–76) Chemotherapy
Botsikas et al.9 2018 PET/CT Switzerland Pro PB and LB Pathology and/or follow-up imaging 80 Initial stage and post-treatment stage Mean ± SD: (48 ± 12.9) NA
Sawicki et al.11 2016 PET/CT Germany Pro LB Pathology and/or follow-up imaging 21 Post-treatment stage Mean ± SD: (59.4 ±11.5) NA
Balci et al.17 2012 PET/CT Turkey Retro PB Pathology and/or follow-up imaging 162 Initial stage and post-treatment stage Mean: 50.6 Surgery
Hahn et al.18 2011 PET/CT Germany Retro PB and LB Follow-up imaging 29 Initial stage Mean (range): 57.5 (35–78) NA
Manohar et al.19 2012 PET/CT India Retro LB Pathology and/or follow-up imaging 111 Post-treatment stage Mean(range): 52 (22–80) Surgery
Niikura et al.25 2011 PET/CT Japan Retro LB Pathology and/or follow-up imaging 225 Initial stage and post-treatment stage Mean: 53.4 Chemotherapy or endocrine therapy
Riegger et al.22 2012 PET/CT Germany Retro LB Pathology and/or follow-up imaging 106 Initial stage Mean ± SD: (57 ± 13) NA
Rager et al.23 2018 PET/CT Switzerland Retro PB and LB Follow-up imaging 25 Initial stage and post-treatment stage Median(range): 5 (38–82) NA
Demir et al.20 2014 PET/CT Turkey Retro LB Pathology and/or follow-up imaging 50 Post-treatment stage Mean ± SD: (53.9 ± 12.3) NA
Hansen et al.24 2015 PET/CT Denmark Pro LB Pathology 18 Post-treatment stage Mean(range): 61.5 (38–76) Surgery
Niikura et al.21 2016 PET/CT Japan Pro PB Pathology and/or follow-up imaging 28 Initial stage and post-treatment stage Median(range): 59 (31–76) Surgery
Shawky et al.26 2016 PET/CT Egypt Pro LB Pathology and/or follow-up imaging 30 Post-treatment stage Mean(range): 53.5 (33–73) Surgery or Chemotherapy or radiotherapy
Teke et al.27 2020 PET/CT Turkey Retro LB Follow-up imaging 62 Initial stage Median(range): 44.5 (8–81) NO

Study and patient characteristics of the included studies for [18F]FDG PET/MRI

Author Year Type of imaging test Study characteristics Patient characteristics
Country Study design Analysis Reference standard No. of patients Clinical indication Mean/Median age Previous treatment
Catalano et al.15 2015 PET/MRI Italy Retro PB Pathology and/or follow-up imaging 109 Initial stage and post-treatment stage Mean ± SD: (58.08 ± 10.7) Surgery
Bruckmann et al.21 2021 PET/MRI Germany Pro PB and LB Pathology 154 Post-treatment stage Mean ± SD: (53.8±11.9) NO
Melsaether et al.10 2016 PET/MRI USA Pro LB Pathology and/or follow-up imaging 51 Initial stage and post-treatment stage Mean(range): 56(32–76) Chemotherapy
Botsikas et al.9 2018 PET/MRI Switzerland Pro PB and LB Pathology and/or follow-up imaging 80 Initial stage and post-treatment stage Mean ± SD: (48 ± 12.9) NA
Sawicki et al.11 2016 PET/MRI Germany Pro LB Pathology and/or follow-up imaging 21 Post-treatment stage Mean ± SD: (59.4 ± 11.5) NA
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