title: Comparative effectiveness of imaging modalities to determine metastatic breast cancer treatment response.
abstract: We performed a systematic review to address the comparative effectiveness of different imaging modalities in evaluating treatment response among metastatic breast cancer patients. We searched seven multidisciplinary electronic databases for relevant publications (January 2003-December 2013) and performed dual abstraction of details and results for all clinical studies that involved stage IV breast cancer patients and evaluated imaging for detecting treatment response. Among 159 citations reviewed, 17 single-institution, non-randomized, observational studies met our inclusion criteria. Several studies demonstrate that changes in PET/CT standard uptake values are associated with changes in tumor volume as determined by bone scan, MRI, and/or CT. However, no studies evaluated comparative test performance between modalities or determined relationships between imaging findings and subsequent clinical decisions. Evidence for imaging's effectiveness in determining treatment response among metastatic breast cancer patients is limited. More rigorous research is needed to address imaging's value in this patient population.
authors.affiliation: Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, Seattle, WA 98109, USA; Department of Health Services, University of Washington School of Public Health, Box 357660, Seattle, WA 98195, USA; Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA; Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address: stophlee@uw.edu.
authors.forename: Christoph I
authors.initials: CI
authors.lastname: Lee
authors.affiliation: Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Pharmaceutical Outcomes Research & Policy Program, School of Pharmacy, University of Washington, Box 257630, Seattle, WA 98195, USA. Electronic address: goldl@u.washington.edu.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Gold
authors.affiliation: Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Departments of Medical Informatics and Clinical Epidemiology and Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Providence Cancer Center, Providence Health & Services, 4805 NE Glisan Street, Portland, OR 97213, USA. Electronic address: nelsonh@ohsu.edu.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Nelson
authors.affiliation: Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Departments of Medical Informatics and Clinical Epidemiology and Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address: chour@ohsu.edu.
authors.forename: Roger
authors.initials: R
authors.lastname: Chou
authors.affiliation: Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA; Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Pharmaceutical Outcomes Research & Policy Program, School of Pharmacy, University of Washington, Box 257630, Seattle, WA 98195, USA; Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA. Electronic address: sramsey@fhcrc.org.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Ramsey
authors.affiliation: Department of Health Services, University of Washington School of Public Health, Box 357660, Seattle, WA 98195, USA; Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA; Pacific Northwest Evidence-Based Practice Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Pharmaceutical Outcomes Research & Policy Program, School of Pharmacy, University of Washington, Box 257630, Seattle, WA 98195, USA. Electronic address: sdsull@u.washington.edu.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D057186:Comparative Effectiveness Research; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D064887:Observational Studies as Topic; D016896:Treatment Outcome
keywords: Bone scan; Computed tomography; Metastatic breast cancer; Positron emission tomography; Treatment response