Staging/restaging performance of F18-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging in breast cancer: A review and meta-analysis.

Objective: This systematic review and meta-analysis was performed to assess the staging/restaging performance of F18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) in breast cancer.

Methods: A comprehensive search was performed in PubMed databases for studies reporting the staging performance of F18-FDG PET/MRI in breast cancer from the inception of these databases to January 29, 2018. Eight studies were included in this systematic review and meta-analysis. Pooled estimates of patient- and lesion-based sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of F18-FDG PET/MRI were calculated alongside 95% confidence intervals (CIs). A summary receiver operating characteristic curve (SROC) was plotted and the area under the SROC curve (AUC) was determined alongside the Q* index.

Results: The patient-based overall pooled sensitivity, specificity, PLR, NLR, DOR, and AUC of F18-FDG PET/MRI for staging in breast cancer were 0.98 (95% CI, 0.95-0.99), 0.87 (95% CI, 0.76-0.95), 4.59 (95% CI, 1.91-11.05), 0.03 (95% CI, 0.01-0.09), 203.07 (95% CI, 50.33-819.38), and 0.99, respectively. The lesion-based overall pooled sensitivity, specificity, PLR, NLR, DOR, and AUC of F18-FDG PET/MRI for staging in breast cancer were 0.91 (95% CI, 0.88-0.94), 0.95 (95% CI, 0.92-0.97), 11.28 (95% CI, 4.25-29.96), 0.07 (95% CI, 0.02-0.22), 286.46 (95% CI, 64.15-1279.17), and 0.99, respectively. The overall diagnostic accuracies (Q* index) of the staging performance of F18-FDG PET/MRI in breast cancer were 0.96 (patient-based analysis) and 0.95 (lesion-based analysis).

Conclusions: F18-FDG PET/MRI has excellent diagnostic staging/restaging performance in patients with breast cancer, and thus should be considered for staging of patients with breast cancer.