Meta-analysis Of Magnetic Resonance Imaging In Detecting Pathological Complete Remission After Neoadjuvant Chemotherapy In Breast Cancer Patients

Purpose.Breast cancer patients with pathological complete remission(pCR)to neoadjuvant chemotherapy have significantly better prognoses than those without pCR.This meta-analysis examines the accuracy of contrastenhanced magnetic resonance imaging(CE-MRI)and diffusion-weighted magnetic resonance imaging(DW-MRI)in detecting the response to neoadjuvant chemotherapy,and compares CE-MRI with ultrasound,mammography,and positron emission tomography-computed tomography(PET/CT).Methods.Medical subject heading terms and relative key words were searched for to generate a compilation of eligible studies.The pooled sensitivity,specificity,diagnostic odds ratio,area under summary receiver operating characteristic curve(AUC)and Youden index(* index)values were carried out using Stata 13.0 and Meta-DiSc to estimate the diagnostic efficacy of CE-MRI,DW-MRI,ultrasound,mammography and PET/CT.Results.54 studies of CE-MRI and 8 studies of DW-MRI were included.The overall AUC values for CE-MRI and DW-MRI were 0.88 and 0.92,and the * index values were 0.80 and 0.85,respectively.According to summary receiver operating characteristic curves,CE-MRI had a higher AUC value and * index than ultrasound and mammography but had similar values as DW-MRI and PET/CT.CE-MRI accurately assessed the pathological complete remission in specificity,while PET/CT or DW-MRI accurately assessed pathological complete remission in sensitivity.Conclusion.This meta-analysis indicates that CE-MRI has high specificity while DW-MRI has high sensitivity in predicting pathological complete remission after neoadjuvant chemotherapy.CE-MRI is more accurate than ultrasound or mammography.Additionally,PET/CT is valuable for predicting pathological complete remission.CE-MRI combined with PET/CT or DW-MRI may allow for a more precise assessment of pathological complete remission.