The Meta-analysis Of The Effect Of CESM Diagnosis Of Breast Cancer Compared With MRI

Objective:To evaluate the accuracy of contrast-enhanced spectral mammography and Magnetic Resonance Imaging for breast cancer diagnosis systematically.To evaluate the value of contrast-enhanced energy mammography in clinical diagnosis of breast cancer from the perspective of evidence-based medicine.Methods:Systematic review and meta-analysis of diagnosis performance of CESM in finding breast cancer.Literatures of CESM and MRI in diagnosis of breast lesions were retrieved,merged,extracted in the databases published from 2008 to 2018,including CNKI,CBM,Cochrance Library,Web of Science,Springerlink,Embase,PubMed,Wanfang and Ovid.Review Manager5.3 was applied to evaluate the publication bias.STATA13.0 software was applied to generate Deek's funnel plot.The heterogeneity of the included literature was tested by Meta Disc 1.4,and the effect model was selected according to the heterogeneity test results,and the sensitivity,specificity,PLR,NLR and DOR were analyzed.After testing the heterogeneity results of literature by using the 95%confidence interval and the forest map,and the DEEK funnel chart of the diagnostic experiment was drawn using the STATA13.0 software to evaluate the publication bias and authenticity of the included literature.Results:A total of 661 literatures were searched,12 literatures were included in this study according to the inclusion and exclusion criteria,totally of 845 cases,980 lesions.The results of summary evaluation for CESM and MRI in diagnosis of breast cancer as follow respectively:The sensitivity were 0.97 and 0.97;the specificity were 0.69 and 0.51;the DOR were 105.44 and 33.73;PLR were 2.94 and 1.95;NLR were 0.05 and 0.07;and the AUC and 95%CI were0.9645(0.9815~0.9558)and 0.9198(0.9468~0.8927)respectively.The range of 95%CI of CESM did not overlap that of MRI.The AUC of CESM was larger than MRI.Deek's funnel plot showed that the publication bias was not significant(P>0.1)in the included articles.Conclusions:By comparing the diagnostic results of CESM and MRI imaging diagnosis methods,the two methods have higher sensitivity,but the specificity of CESM is higher than that of MRI,and the SROC curve of CESM is higher.The lower area(AUC)and Q~*index are statistically different from MRI.Meta-analysis indicates that CEMS is a valuable diagnostic method which had high veracity in the detecting breast cancer compared with MRI,which is worth further promotion in the clinic.