Diagnostic performance of contrast-enhanced spectral mammography: Systematic review and meta-analysis

Alberto Stefano Tagliafico; Bianca Bignotti; Federica Rossi; Alessio Signori; Maria Pia Sormani; Francesca Valdora; Massimo Calabrese; Nehmat Houssami

doi:10.1016/j.breast.2016.04.008

Diagnostic performance of contrast-enhanced spectral mammography: Systematic review and meta-analysis

Breast. 2016 Aug:28:13-9. doi: 10.1016/j.breast.2016.04.008. Epub 2016 May 7.

Authors

Alberto Stefano Tagliafico¹, Bianca Bignotti², Federica Rossi³, Alessio Signori⁴, Maria Pia Sormani⁴, Francesca Valdora⁵, Massimo Calabrese⁶, Nehmat Houssami⁷

Affiliations

¹ Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via L.B. Alberti, 16132 Genoa, Italy. Electronic address: [email protected].
² Radiology Department, Department of Health Sciences, University of Genoa, Via Pastore, 16132 Genoa, Italy.
³ School of Medicine, University of Genoa, Via Pastore, 16132 Genoa, Italy.
⁴ Institute of Statistics, Department of Health Sciences, University of Genoa, Via Pastore, 16132 Genoa, Italy.
⁵ Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via L.B. Alberti, 16132 Genoa, Italy.
⁶ Radiology Department, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Largo Rosanna Benzi 10, 16138 Genoa, Italy.
⁷ School of Public Health, Sydney Medical School, University of Sydney, 2006, Australia.

PMID: 27161411
DOI: 10.1016/j.breast.2016.04.008

Abstract

Purpose: To estimate sensitivity and specificity of CESM for breast cancer diagnosis.

Methods: Systematic review and meta-analysis of the accuracy of CESM in finding breast cancer in highly selected women. We estimated summary receiver operating characteristic curves, sensitivity and specificity according to quality criteria with QUADAS-2.

Results: Six hundred four studies were retrieved, 8 of these reporting on 920 patients with 994 lesions, were eligible for inclusion. Estimated sensitivity from all studies was: 0.98 (95% CI: 0.96-1.00). Specificity was estimated from six studies reporting raw data: 0.58 (95% CI: 0.38-0.77). The majority of studies were scored as at high risk of bias due to the very selected populations.

Conclusion: CESM has a high sensitivity but very low specificity. The source studies were based on highly selected case series and prone to selection bias. High-quality studies are required to assess the accuracy of CESM in unselected cases.

Keywords: Accuracy; Contrast-enhanced spectral mammography; Meta-analysis; Sensitivity; Specificity; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Breast Neoplasms / diagnostic imaging*
Breast Neoplasms / pathology
Contrast Media
Female
Humans
Mammography / methods*
Sensitivity and Specificity
Tumor Burden

Substances

Contrast Media