title: Role of Magnetic Resonance Imaging in Detection of Pathologic Complete Remission in Breast Cancer Patients Treated With Neoadjuvant Chemotherapy: A Meta-analysis.
abstract: Pathologic complete remission after neoadjuvant chemotherapy has a role in guiding the management of breast cancer. The present meta-analysis examined the accuracy of contrast-enhanced magnetic resonance imaging (CE-MRI) and diffusion-weighted magnetic resonance imaging (DW-MRI) in detecting the response to neoadjuvant chemotherapy and compared CE-MRI with ultrasonography, mammography, and positron emission tomography/computed tomography (PET/CT). Medical subject heading terms and related keywords were searched to generate a compilation of eligible studies. The pooled sensitivity, specificity, diagnostic odds ratio, area under summary receiver operating characteristic curve (AUC), and Youden index (Q* index) were used to estimate the diagnostic efficacy of CE-MRI, DW-MRI, ultrasonography, mammography, and PET/CT. A total of 54 studies of CE-MRI and 8 studies of DW-MRI were included. The overall AUC and the Q* index values for CE-MRI and DW-MRI were 0.88 and 0.94 and 0.80 and 0.85, respectively. According to the summary receiver operating characteristic curves, CE-MRI resulted in a higher AUC value and Q* index compared with ultrasonography and mammography but had values similar to those of DW-MRI and PET/CT. CE-MRI accurately assessed pathologic complete remission in specificity, and PET/CT and DW-MRI accurately assessed pathologic complete remission in sensitivity. The present meta-analysis indicates that CE-MRI has high specificity and DW-MRI has high sensitivity in predicting pathologic complete remission after neoadjuvant chemotherapy. CE-MRI is more accurate than ultrasonography or mammography. Additionally, PET/CT is valuable for predicting pathologic complete remission. CE-MRI, combined with PET/CT or DW-MRI, might allow for a more precise assessment of pathologic complete remission.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: Yan-Lin
authors.initials: YL
authors.lastname: Gu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: Si-Meng
authors.initials: SM
authors.lastname: Pan
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
authors.forename: Zhi-Xue
authors.initials: ZX
authors.lastname: Yang
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. Electronic address: jiang_guoqin@163.com.
authors.forename: Guo-Qin
authors.initials: GQ
authors.lastname: Jiang
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D020360:Neoadjuvant Therapy; D012074:Remission Induction
keywords: Breast cancer; MRI; Meta-analysis; NAC; pCR