Diagnostic performance of dedicated positron emission mammography using fluorine-18-fluorodeoxyglucose in women with suspicious breast lesions: a meta-analysis

Abstract

Background: The diagnostic performance of dedicated positron emission mammography (PEM) using fluorine-18-fluorodeoxyglucose (FDG) in evaluating suspicious breast lesions has been investigated by several authors, with conflicting results. Aim of our study is to meta-analyze published data about this topic, in order to add evidence-based data in this setting.

Materials and methods: We carried out a comprehensive computer literature search of studies published in the PubMed/MEDLINE, Scopus, or Embase databases through February 10, 2013, regarding the diagnostic performance of PEM using FDG in women with breast lesions. Only studies comprising ≥ 10 patients who underwent PEM were included in the meta-analysis, for statistical purposes. Pooled sensitivity and specificity on a per lesion-based analysis were calculated to assess the diagnostic performance of PEM using FDG in this setting.

Results: Our meta-analysis evaluated 8 studies comprising 873 women with breast lesions. Pooled sensitivity and specificity values of PEM using FDG in women with suspected breast malignancy were 85% (95% CI, 83%-88%) and 79% (95% CI, 74%-83%), respectively, on a per lesion-based analysis. The included studies were heterogeneous in their estimate of sensitivity and specificity.

Conclusion: PEM using FDG is a sensitive and specific tool for the evaluation of suspicious breast lesions. The detection of additional lesions and extensive intraductal involvement is improved, with comparable accuracy, over that of MRI in the depiction of invasive breast cancers.

Keywords: Accuracy of diagnostic studies; Breast malignancy; PEM; Sensitivity and specificity; Statistical pooled evaluation.