title: Contrast-enhanced ultrasonography in qualitative diagnosis of sentinel lymph node metastasis in breast cancer: A meta-analysis.
abstract: OBJECTIVE
  This meta-analysis aims to determine the accuracy of contrast-enhanced ultrasonography (CEUS) in the qualitative diagnosis of metastatic sentinel lymph node (SLN) for patients with breast cancer.
  
  
  METHODS
  We screened PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CBM, and CNKI databases. All analyses were calculated using the STATA software, version 12.0 (Stata Corp, College Station, TX, USA). We calculated the summary statistics for sensitivity (Sen), specificity (Spe), positive and negative likelihood ratios (LR + /LR-), diagnostic odds ratio (DOR) and receiver operating characteristic (SROC) curve. Thirteen articles that met all inclusion criteria were included in this meta-analysis.
  
  
  RESULTS
  A total of 876 breast cancer patients were assessed, including 372 patients with metastatic SLN and 504 patients without metastatic SLN. All SLN were histologically confirmed after conducting CEUS. The pooled Sen was 0.80 (95%CI = 0.76-0.84); the pooled Spe was 0.94 (95% CI = 0.91-0.96). The pooled LR + was 6.28 (95%CI = 3.61-10.92); the pooled negative LR - was 0.218 (95% CI = 0.10-0.31). The pooled DOR of CEUS in qualitative diagnosis of SLN metastasis was 49.10 (95% CI = 27.89-86.45). The area under the SROC curve was 0.937 (standard error [SE] =0.0128).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that CEUS may have high a diagnostic accuracy in testing for metastatic SLN in breast cancer. Thus, CEUS may be a good tool for differential diagnosis between metastatic and non-metastatic SLN.
authors.affiliation: Department of Ultrasonography, The First Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Yi-Xia
authors.initials: YX
authors.lastname: Zhang
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Wang
authors.forename: Shu
authors.initials: S
authors.lastname: Kang
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Geng
mesh_terms: D001943:Breast Neoplasms / Q000556:secondary* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D016217:Ultrasonography, Mammary
chemical_list: D003287:Contrast Media