A systematic review and meta-analysis on the diagnostic accuracy of whole-body PET /CT for distant metastases in breast cancers

ABSTRACT

Background@#Breast cancer is the second most common malignancy globally. This study is a systematic review and meta-analysis assessing whole-body PET/CT using 18F-FDG in detecting breast carcinoma distant metastases as an update to the study of Xu et al.@*Objective@#To determine the diagnostic accuracy of whole-body PET/CT in distant metastasis detection among breast cancer patients.@*Methods@#The MEDLINE database was systematically searched for articles evaluating whole-body PET/CT in distant metastasis detection among breast cancer patients. Sensitivity, specificity, likelihood ratios and predictive values were derived by the three independent readers. Summary receiver operating characteristic curves were plotted.@*Results@#Fifteen studies (n=4175) were included with pooled sensitivities, specificities, positive and negative likelihood ratios, positive and negative predictive values (with 95% confidence intervals) of 0.98 (0.97-0.99), 0.98 (0.98-0.99), 86.6 (63.6-117.9), 0.01 (0.01-0.02), 0.94 (0.92-0.95) and 0.99 (0.995-0-.998), respectively. Pooled positive and negative predictive values with a prevalence of 13.6% are 0. 93 and 0.99, respectively.@*Conclusion@#Whole-body PET/CT with 18F-FDG provides excellent detection of distant metastases in breast cancer and is recommended in assessing patients in earlier stages of the disease, not only in the later stages, especially in more aggressive tumors.