Diagnosing Bone Metastases in Breast Cancer: A Systematic Review and Network Meta-Analysis on Diagnostic Test Accuracy Studies of 2-[18F]FDG-PET/CT, 18F-NaF-PET/CT, MRI, Contrast-Enhanced CT, and Bone Scintigraphy.

作者：O. Gerke, Mohammad Naghavi-Behzad, S. T. Nygaard, Victoria Raha Sigaroudi, M. Vogsen, Werner Vach, M. G. Hildebrandt · 发表于：Seminars in nuclear medicine · 年份：2024 · DOI：10.1053/j.semnuclmed.2024.10.008 · 被引用次数：14 · 研究领域：Medicine

This systematic review and network meta-analysis aimed to compare the diagnostic accuracy of 2-[18F]FDG-PET/CT, 18F-NaF-PET/CT, MRI, contrast-enhanced CT, and bone scintigraphy for diagnosing bone metastases in patients with breast cancer. Following PRISMA-DTA guidelines, we reviewed studies assessing 2-[18F]FDG-PET/CT, 18F-NaF-PET/CT, MRI, contrast-enhanced CT, and bone scintigraphy for diagnosing bone metastases in high-stage primary breast cancer (stage III or IV) or known primary breast cancer with suspicion of recurrence (staging or re-staging). A comprehensive search of MEDLINE/PubMed, Scopus, and Embase was conducted until February 2024. Inclusion criteria were original studies using these imaging methods, excluding those focused on AI/machine learning, primary breast cancer without metastases, mixed cancer types, preclinical studies, and lesion-based accuracy. Preference was given to studies using biopsy or follow-up as the reference standard. Risk of bias was assessed using QUADAS-2. Screening, bias assessment, and data extraction were independently performed by two researchers, with discrepancies resolved by a third. We applied bivariate random-effects models in meta-analysis and network meta-analyzed differences in sensitivity and specificity between the modalities. Forty studies were included, with 29 contributing to the meta-analyses. Of these, 13 studies investigated one single modality only. Both 2-[18F]FDG-PET/CT (sensitivity: 0.94, 95% CI: 0.89-0.97; specific...