Meta-analysis of contrast-enhanced ultrasound for the differentiation of benign and malignant breast lesions
Meta-analysis of contrast-enhanced ultrasound for the differentiation of benign and malignant breast lesions
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DOI：
10.1177/0284185113517115
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发表时间：
2015-01-01
期刊：
影响因子：
1.3
通讯作者：
Zheng, Hong Yu
中科院分区：
文献类型：
--
作者：
Hu, Qiao;Wang, Xiao Yan;Zheng, Hong Yu
背景：超声造影（CEUS）是一种用于评估乳腺病变的非侵入性方法。CEUS在乳腺癌诊断中的准确性从未被系统评估过。目的：使用荟萃分析确定CEUS在乳腺良恶性病变鉴别中的总体表现。材料和方法：检索PubMed、Embase、科克伦图书馆和2012年10月之前发表的参考文献。纳入了使用组织病理学结果作为黄金参考来评估CEUS在疑似乳腺癌患者中的诊断性能的已发表研究以及计算诊断结果所需的数据。采用诊断性研究质量评估（QUADAS）工具对最终荟萃分析合格研究的质量进行评估。计算敏感性、特异性、受试者工作特征曲线（summarizedreceiver-operatingcharacteristic curve，sROC）和曲线下面积（area under the curve），分析CEUS.Results的诊断性能。Meta回归分析证实造影剂是导致异质性的最显著因素（P = 0.0012，相对诊断优势比[DOR] = 7.06）。与Levovist相比，使用含全氟微泡（Sonovue或Optison）显著提高了诊断精度。CEUS诊断乳腺病变的敏感性和特异性加权估计值为0.86结论：CEUS对乳腺肿块的定性诊断具有良好的敏感性和特异性，对临床可疑乳腺肿块的诊断具有重要的参考价值。
Background: Contrast-enhanced ultrasound (CEUS) is a non-invasive method for the assessment of breast lesions. The accuracy of CEUS in diagnosing of breast cancer has never been systematically assessed.Purpose: To determine the overall performance of CEUS in the differentiation of benign and malignant breast lesions using meta-analysis.Material and Methods: PubMed, Embase, Cochrane Library, and article references published before October 2012 were searched. Published studies that used histopathologic results as golden reference to assess the diagnostic performance of CEUS in patients suspected of having breast cancer and the data necessary to calculate the diagnostic results were included. The qualities of eligible studies for final meta-analysis were assessed by using the quality assessment of diagnostic studies (QUADAS) instrument. Sensitivity, specificity, summary receiver-operating characteristic (sROC) curves, and area under the curve were calculated to examine the diagnostic performance of CEUS.Results: Of 16 eligible studies, 957 breast lesions were included in the original meta-analysis, among which heterogeneity arising from factors other than threshold effect was explored. Meta-regression analysis confirmed the contrast agent was the most significant factor cause of heterogeneity (P = 0.0012, relative diagnostic odds ratio [DOR] = 7.06). The use of perfluoro containing microbubbles (Sonovue or Optison) significantly increased the diagnostic precision compared with Levovist. The pooled weighted estimates of sensitivity and specificity for CEUS in the diagnosis of breast lesions were 0.86 (95% confidence interval [CI], 0.83, 0.89) and 0.79 (95% CI, 0.75, 0.83), respectively.Conclusion: CEUS has good sensitivity and specificity in the characterization of breast lesions and can potentially help to select suspicious breast mass for surgery.