Comparison of [¹⁸F] FDG PET/CT and [¹⁸F]FDG PET/MRI in the Detection of Distant Metastases in Breast Cancer: A Meta-Analysis

Purpose: This meta-analysis aims to assess and compare the diagnostic effectiveness of [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI for distant metastases in breast cancer patients.

Methods: A comprehensive search of the PubMed and Embase databases was performed to identify relevant articles until September 22, 2023. Studies were eligible to be included if they assessed the diagnostic performance of [¹⁸F] FDG PET/CT and/or [¹⁸F] FDG PET/MRI in detecting distant metastases of breast cancer patients. The DerSimonian and Laird method was used to assess sensitivity and specificity, and then transformed through the Freeman-Tukey double arcsine transformation.

Results: 29 articles consisting of 3779 patients were finally included in this study. The overall sensitivity of [¹⁸F] FDG PET/CT in diagnosing distant metastases of breast cancer was 0.96 (95% CI: 0.93-0.98), and the overall specificity was 0.95 (95% CI: 0.92-0.97). The overall sensitivity of [¹⁸F] FDG PET/MRI was 1.00 (95% CI: 0.97-1.00), and the specificity was 0.97 (95% CI: 0.94-1.00). The results suggested that [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI appears to have similar sensitivity (P = .16) and specificity (P = .30) in diagnosing distant metastases of breast cancer.

Conclusions: The results of our meta-analysis indicated that [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI in diagnosing distant metastases of breast cancer appear to have similar sensitivity and specificity. Patients who have access to only one of these modalities will not have the accuracy of their staging compromised. In clinical practice, both of these imaging techniques have their respective strengths and limitations, and physicians should take these into account when making the most suitable choice for patients.