Diffusion-weighted imaging in monitoring the pathological response to neoadjuvant chemotherapy in patients with breast cancer: a meta-analysis
Diffusion-weighted imaging in monitoring the pathological response to neoadjuvant chemotherapy in patients with breast cancer: a meta-analysis
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DOI：
10.1186/s12957-018-1438-y
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发表时间：
2018-07-18
影响因子：
3.2
通讯作者：
Dong, Ting
中科院分区：
文献类型：
--
作者：
Gao, Wen;Guo, Ning;Dong, Ting
背景：弥散加权成像（DWI）被建议作为一种非侵入性和非放射性成像方式，用于识别接受新辅助化疗（NACT）的乳腺癌患者的病理完全缓解（pCR）。越来越多的试验正在这方面进行研究，一些研究发现 DWI 与传统成像技术相比具有优越的性能。然而，DWI 的效率仍存在争议。本荟萃分析旨在评估 DWI 对乳腺癌患者 pCR 与 NACT 检测的准确性。方法：汇总敏感性、特异性和诊断比值比 (DOR) 来评估 DWI 对 NACT 的诊断效果。还计算了汇总受试者工作特征曲线 (SROC)、SROC 曲线下面积 (AUC) 和约登指数 (*Q)。使用单因素荟萃回归分析探讨了纳入研究中异质性的可能来源。分别使用 Deek 漏斗图和 QUADAS-2 表格评估发表偏倚和质量评估。结果：我们的分析纳入了 20 项研究，纳入了 1490 名参与者。汇总估计值显示敏感性为 0.89 (95% CI, 0.86-0.91)，特异性为 0.72 (95% CI, 0.68-0.75)，DOR 为 27.00 (95% CI, 15.60-46.73)。 SROC曲线和*Q指数的AUC分别为0.9088和0.8408。荟萃回归分析结果显示，pCR率、研究人群的持续时间和研究设计并不是异质性的来源。结论：我们的荟萃分析发现，DWI在诊断接受NACT治疗的乳腺癌患者pCP方面具有相对较高的敏感性和特异性。这一发现表明，使用 DWI 可以对 NACT 的 pCR 进行准确且精确的评估。
Background: Diffusion-weighted imaging (DWI) is suggested as an non-invasive and non-radioactive imaging modality in the identification of pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NACT). A growing number of trials have been investigating in this aspect and some studies found a superior performance of DWI compared with conventional imaging techniques. However, the efficiency of DWI is still in dispute. This meta-analysis aims at evaluating the accuracy of DWI in the detection of pCR to NACT in patients with breast cancer.Methods: Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were drawn to estimate the diagnostic effect of DWI to NACT. Summary receiver operating characteristic curve (SROC), the area under the SROC curve (AUC), and Youden index (*Q) were also calculated. The possible sources of heterogeneity among the included studies were explored using single-factor meta-regression analyses. Publication bias and quality assessment were assessed using Deek's funnel plot and QUADAS-2 form respectively.Results: Twenty studies incorporated 1490 participants were enrolled in our analysis. Pooled estimates revealed a sensitivity of 0.89 (95% CI, 0.86-0.91), a specificity of 0.72 (95% CI, 0.68-0.75), and a DOR of 27.00 (95% CI, 15.60-46.73). The AUC of SROC curve and *Q index were 0.9088 and 0.8408, respectively. The results of meta-regression analyses showed that pCR rate, time duration of study population, and study design were not the sources of heterogeneity.Conclusion: A relatively high sensitivity and specificity of DWI in diagnosing pCP for patients with breast cancer underwent NACT treatment was found in our meta-analysis. This finding indicated that the use of DWI might provide an accurate and precise assessment of pCR to NACT.