FDG-PET/CT and MRI for evaluation of pathologic response to neoadjuvant chemotherapy in patientswith breast cancer

A meta-analysis of diagnostic accuracy studies

Sara Sheikhbahaei, Tyler J. Trahan, Jennifer Xiao, Mehdi Taghipour, Mena Esther Mena, Roisin M. Connolly, Rathan M. Subramaniam

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction. This study compared the diagnostic test accuracy of magnetic resonance imaging (MRI) with that of18F-fluoro-2-glucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging in assessment of response to neoadjuvant chemotherapy (NAC) in breast cancer. Methods. A systematic search was performed in PubMed and EMBASE (last updated in June 2015). Studies investigating the performance of MRI and FDG-PET or FDG-PET/CT imaging during or after completion of NAC in patients with histologically proven breast cancer were eligible for inclusion. We considered only studies reporting a direct comparison between these imaging modalities to establish precise summary estimates in the same setting of patients. Pathologic response was considered as the reference standard. Two authors independently screened and selected studies that met the inclusion criteria and extracted the data. Results. A total of 10 studies were included.The pooled estimates of sensitivity and specificity across all included studies were 0.71 and 0.77 for FDG-PET/CT (n 5 535) and 0.88 and 0.55 for MRI (n 5 492), respectively. Studies were subgrouped according to the time of therapy assessment. In the intra-NAC setting, FDG-PET/CT imaging out performed MRI with fairly similar pooled sensitivity (0.91 vs. 0.89) and higher specificity (0.69 vs. 0.42). However, MRI appeared to have higher diagnostic accuracy than FDG-PET/CT imaging when performed after the completion of NAC, with significantly higher sensitivity (0.88 vs. 0.57). Conclusion. Analysis of the available studies of patients with breast cancer indicates that the timing of imaging for NAC response assessment exerts a major influenceonthe estimates of diagnostic accuracy. FDG-PET/CT imaging outperformed MRI in intra-NAC assessment, whereas the overall performance of MRI was higher after completion of NAC, before surgery.

Original languageEnglish (US)
Pages (from-to)931-939
Number of pages9
JournalOncologist
Volume21
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Meta-Analysis
Magnetic Resonance Imaging
Breast Neoplasms
Drug Therapy
Routine Diagnostic Tests
PubMed
Glucose
Sensitivity and Specificity

Keywords

  • F-fluoro-2-glucose-positron emission tomography/computed tomography
  • Breast cancer
  • Magnetic resonance imaging
  • Meta-analysis
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

FDG-PET/CT and MRI for evaluation of pathologic response to neoadjuvant chemotherapy in patientswith breast cancer : A meta-analysis of diagnostic accuracy studies. / Sheikhbahaei, Sara; Trahan, Tyler J.; Xiao, Jennifer; Taghipour, Mehdi; Esther Mena, Mena; Connolly, Roisin M.; Subramaniam, Rathan M.

In: Oncologist, Vol. 21, No. 8, 01.08.2016, p. 931-939.

Research output: Contribution to journalArticle

Sheikhbahaei, Sara ; Trahan, Tyler J. ; Xiao, Jennifer ; Taghipour, Mehdi ; Esther Mena, Mena ; Connolly, Roisin M. ; Subramaniam, Rathan M. / FDG-PET/CT and MRI for evaluation of pathologic response to neoadjuvant chemotherapy in patientswith breast cancer : A meta-analysis of diagnostic accuracy studies. In: Oncologist. 2016 ; Vol. 21, No. 8. pp. 931-939.
@article{8d479318f1ce4aa88bb55c92c43e3980,
title = "FDG-PET/CT and MRI for evaluation of pathologic response to neoadjuvant chemotherapy in patientswith breast cancer: A meta-analysis of diagnostic accuracy studies",
abstract = "Introduction. This study compared the diagnostic test accuracy of magnetic resonance imaging (MRI) with that of18F-fluoro-2-glucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging in assessment of response to neoadjuvant chemotherapy (NAC) in breast cancer. Methods. A systematic search was performed in PubMed and EMBASE (last updated in June 2015). Studies investigating the performance of MRI and FDG-PET or FDG-PET/CT imaging during or after completion of NAC in patients with histologically proven breast cancer were eligible for inclusion. We considered only studies reporting a direct comparison between these imaging modalities to establish precise summary estimates in the same setting of patients. Pathologic response was considered as the reference standard. Two authors independently screened and selected studies that met the inclusion criteria and extracted the data. Results. A total of 10 studies were included.The pooled estimates of sensitivity and specificity across all included studies were 0.71 and 0.77 for FDG-PET/CT (n 5 535) and 0.88 and 0.55 for MRI (n 5 492), respectively. Studies were subgrouped according to the time of therapy assessment. In the intra-NAC setting, FDG-PET/CT imaging out performed MRI with fairly similar pooled sensitivity (0.91 vs. 0.89) and higher specificity (0.69 vs. 0.42). However, MRI appeared to have higher diagnostic accuracy than FDG-PET/CT imaging when performed after the completion of NAC, with significantly higher sensitivity (0.88 vs. 0.57). Conclusion. Analysis of the available studies of patients with breast cancer indicates that the timing of imaging for NAC response assessment exerts a major influenceonthe estimates of diagnostic accuracy. FDG-PET/CT imaging outperformed MRI in intra-NAC assessment, whereas the overall performance of MRI was higher after completion of NAC, before surgery.",
keywords = "F-fluoro-2-glucose-positron emission tomography/computed tomography, Breast cancer, Magnetic resonance imaging, Meta-analysis, Neoadjuvant chemotherapy",
author = "Sara Sheikhbahaei and Trahan, {Tyler J.} and Jennifer Xiao and Mehdi Taghipour and {Esther Mena}, Mena and Connolly, {Roisin M.} and Subramaniam, {Rathan M.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1634/theoncologist.2015-0353",
language = "English (US)",
volume = "21",
pages = "931--939",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",
number = "8",

}

TY - JOUR

T1 - FDG-PET/CT and MRI for evaluation of pathologic response to neoadjuvant chemotherapy in patientswith breast cancer

T2 - A meta-analysis of diagnostic accuracy studies

AU - Sheikhbahaei, Sara

AU - Trahan, Tyler J.

AU - Xiao, Jennifer

AU - Taghipour, Mehdi

AU - Esther Mena, Mena

AU - Connolly, Roisin M.

AU - Subramaniam, Rathan M.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Introduction. This study compared the diagnostic test accuracy of magnetic resonance imaging (MRI) with that of18F-fluoro-2-glucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging in assessment of response to neoadjuvant chemotherapy (NAC) in breast cancer. Methods. A systematic search was performed in PubMed and EMBASE (last updated in June 2015). Studies investigating the performance of MRI and FDG-PET or FDG-PET/CT imaging during or after completion of NAC in patients with histologically proven breast cancer were eligible for inclusion. We considered only studies reporting a direct comparison between these imaging modalities to establish precise summary estimates in the same setting of patients. Pathologic response was considered as the reference standard. Two authors independently screened and selected studies that met the inclusion criteria and extracted the data. Results. A total of 10 studies were included.The pooled estimates of sensitivity and specificity across all included studies were 0.71 and 0.77 for FDG-PET/CT (n 5 535) and 0.88 and 0.55 for MRI (n 5 492), respectively. Studies were subgrouped according to the time of therapy assessment. In the intra-NAC setting, FDG-PET/CT imaging out performed MRI with fairly similar pooled sensitivity (0.91 vs. 0.89) and higher specificity (0.69 vs. 0.42). However, MRI appeared to have higher diagnostic accuracy than FDG-PET/CT imaging when performed after the completion of NAC, with significantly higher sensitivity (0.88 vs. 0.57). Conclusion. Analysis of the available studies of patients with breast cancer indicates that the timing of imaging for NAC response assessment exerts a major influenceonthe estimates of diagnostic accuracy. FDG-PET/CT imaging outperformed MRI in intra-NAC assessment, whereas the overall performance of MRI was higher after completion of NAC, before surgery.

AB - Introduction. This study compared the diagnostic test accuracy of magnetic resonance imaging (MRI) with that of18F-fluoro-2-glucose-positron emission tomography/ computed tomography (FDG-PET/CT) imaging in assessment of response to neoadjuvant chemotherapy (NAC) in breast cancer. Methods. A systematic search was performed in PubMed and EMBASE (last updated in June 2015). Studies investigating the performance of MRI and FDG-PET or FDG-PET/CT imaging during or after completion of NAC in patients with histologically proven breast cancer were eligible for inclusion. We considered only studies reporting a direct comparison between these imaging modalities to establish precise summary estimates in the same setting of patients. Pathologic response was considered as the reference standard. Two authors independently screened and selected studies that met the inclusion criteria and extracted the data. Results. A total of 10 studies were included.The pooled estimates of sensitivity and specificity across all included studies were 0.71 and 0.77 for FDG-PET/CT (n 5 535) and 0.88 and 0.55 for MRI (n 5 492), respectively. Studies were subgrouped according to the time of therapy assessment. In the intra-NAC setting, FDG-PET/CT imaging out performed MRI with fairly similar pooled sensitivity (0.91 vs. 0.89) and higher specificity (0.69 vs. 0.42). However, MRI appeared to have higher diagnostic accuracy than FDG-PET/CT imaging when performed after the completion of NAC, with significantly higher sensitivity (0.88 vs. 0.57). Conclusion. Analysis of the available studies of patients with breast cancer indicates that the timing of imaging for NAC response assessment exerts a major influenceonthe estimates of diagnostic accuracy. FDG-PET/CT imaging outperformed MRI in intra-NAC assessment, whereas the overall performance of MRI was higher after completion of NAC, before surgery.

KW - F-fluoro-2-glucose-positron emission tomography/computed tomography

KW - Breast cancer

KW - Magnetic resonance imaging

KW - Meta-analysis

KW - Neoadjuvant chemotherapy

UR - http://www.scopus.com/inward/record.url?scp=84981488793&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84981488793&partnerID=8YFLogxK

U2 - 10.1634/theoncologist.2015-0353

DO - 10.1634/theoncologist.2015-0353

M3 - Article

VL - 21

SP - 931

EP - 939

JO - Oncologist

JF - Oncologist

SN - 1083-7159

IS - 8

ER -