Huimin Li1, Liang Yao2, Penghui Jin3, Lidong Hu3, Xiaofei Li4, Tiankang Guo5, Kehu Yang6. 1. Department of General Surgery, Gansu Province People's Hospital, Donggang West Road, Lanzhou, 730000, Gansu, China; School of Clinical Medical Sciences, Ningxia Medical University, Shengli Street, Yinchuan, 750000, China. 2. Clinical Division of Hong Kong Baptist University, Hong Kong, China. 3. School of Clinical Medical Sciences, Gansu University of Traditional Chinese Medicine, Lanzhou, Gansu, 730000, China. 4. Department of General Surgery, Gansu Province People's Hospital, Donggang West Road, Lanzhou, 730000, Gansu, China. 5. Department of General Surgery, Gansu Province People's Hospital, Donggang West Road, Lanzhou, 730000, Gansu, China. Electronic address: tiankangguo2016@163.com. 6. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China. Electronic address: kehuyangebm2006@126.com.
Abstract
BACKGROUND: Neoadjuvant chemotherapy (NAC) has become an essential treatment for breast cancer. However, there is still no consensus on the best tool to evaluate pathological response to NAC. METHODS: Two reviewers systematically searched Cochrane, PubMed, EMBASE, Web of Science, and CBM (last updated in February 2017) for eligible articles. We independently screened and selected studies that conformed to the inclusion criteria and extracted the requisite data. Pooled sensitivity, specificity, and the area under the SROC curve were calculated to estimate the diagnostic accuracy of magnetic resonance imaging (MRI) and positron emission computed tomography (PET/CT). And the relative DOR (RDOR) was used to compare accuracy for levels of the covariable. RESULTS: Thirteen studies involving 575 patients who underwent MRI and 618 who underwent PET/CT were included in our analysis. The pooled sensitivity and specificity of MRI were 0.88 (95% CI: 0.78-0.94) and 0.69 (95% CI: 0.51-0.83), respectively. The corresponding values for PET/CT were 0.77 (95% CI: 0.58-0.90) and 0.78 (95% CI: 0.63-0.88), respectively. The area under the SROC curve for MRI and PET/CT were 0.88 and 0.84, respectively. And the RDOR = 1.44 (95% CI, 0.46-4.47 P = 0.83). CONCLUSION: MRI had a higher sensitivity and PET/CT had a higher specificity in predicting the pathologic response after NAC in patients with breast cancer. According to the area under the SROC curve and anatomic discriminative resolution, MRI is the more suitable recommendation for predicting the pathologic response after NAC.
BACKGROUND: Neoadjuvant chemotherapy (NAC) has become an essential treatment for breast cancer. However, there is still no consensus on the best tool to evaluate pathological response to NAC. METHODS: Two reviewers systematically searched Cochrane, PubMed, EMBASE, Web of Science, and CBM (last updated in February 2017) for eligible articles. We independently screened and selected studies that conformed to the inclusion criteria and extracted the requisite data. Pooled sensitivity, specificity, and the area under the SROC curve were calculated to estimate the diagnostic accuracy of magnetic resonance imaging (MRI) and positron emission computed tomography (PET/CT). And the relative DOR (RDOR) was used to compare accuracy for levels of the covariable. RESULTS: Thirteen studies involving 575 patients who underwent MRI and 618 who underwent PET/CT were included in our analysis. The pooled sensitivity and specificity of MRI were 0.88 (95% CI: 0.78-0.94) and 0.69 (95% CI: 0.51-0.83), respectively. The corresponding values for PET/CT were 0.77 (95% CI: 0.58-0.90) and 0.78 (95% CI: 0.63-0.88), respectively. The area under the SROC curve for MRI and PET/CT were 0.88 and 0.84, respectively. And the RDOR = 1.44 (95% CI, 0.46-4.47 P = 0.83). CONCLUSION: MRI had a higher sensitivity and PET/CT had a higher specificity in predicting the pathologic response after NAC in patients with breast cancer. According to the area under the SROC curve and anatomic discriminative resolution, MRI is the more suitable recommendation for predicting the pathologic response after NAC.
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