Comparison of whole-body PET/PET-CT and conventional imaging procedures for distant metastasis staging in patients with breast cancer: a meta-analysis.

Aim: To compare the performance of whole-body PET/PET-CT with that of conventional imaging procedures for the overall assessment of distant metastasis in patients with breast cancer. Materials and Methods: The authors performed a meta-analysis of all available studies of whole-body PET/PET-CT compared with conventional imaging procedures. They calculated sensitivities, specificities, positive likelihood ratios, negative likelihood ratios, and constructed summary receiver operating characteristic (ROC) curves using bivariate regression models for whole-body PET/PET-CT and conventional imaging procedures, respectively. Results: Across six studies (609 patients), sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios of whole-body PET/PET-CT were 0.99 (95% confidence interval [CI] = 0.88-1.00), 0.95 (95% CI = 0.89-0.98), 21.1 (95% CI = 8.2-55.5), and 0.02 (95% CI = 0.001-0.13), respectively, and of conventional imaging procedures they were 0.57 (95% CI = 0.37-0.74), 0.88 (95% CI = 0.78-0.94), 4.8 (95% CI = 2.8-8.2) and 0.49 (95% CI = 0.33-0.74), respectively. Conclusion: Compared with conventional imaging procedures, whole-body PET/PET-CT had excellent diagnostic performance for distant metastasis staging in patients with breast cancer.