Diagnostic performance of dynamic contrast‐enhanced magnetic resonance imaging for breast cancer detection: An update meta‐analysis

Objective To evaluate the diagnostic performance of dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) for breast cancer identification. Methods A comprehensive electronic systematic searching of Medline, Ovid, EMBASE, Web of Science, CNK, and Cochrane Library databases was performed up to 2 August 2021. Clinical studies associated with DCE‐MRI for breast cancer detection were screened and inlcuded in the meta‐analysis. The data of true positive(tp), false positive(fp), false negative(fn) and true negative(tn) was extracted from includded studies. The sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic (SROC) were pooled under fixed or random effect models. Publication bias was evaluated by Deek's funnel plot. Results A final set of 15 studies with 1321 breast lesions were included in the present work. The pooled diagnostic sensitivity, specificity, and DOR were 0.87 (95% confidence interval [CI] 0.81–0.92), 0.74 (95% CI 0.68–0.80), and 18.83 (95% CI 9.07–36.54), respectively, and the area under the SROC was 0.86 (95% CI 0.82–0.88). Given a pretest probability of 50%, the positive post‐test probability was 77%, and the negative post‐test probability was 14%. Deek's funnel plot indicated low publication bias (p = 0.61). Conclusion DCE‐MRI is a noninvasive method of breast cancer diagnosis for suspected malignant breast lesions with relative high diagnostic sensitivity and specificity.
Likelihood ratio and post‐test probability are important indexes of diagnostic tests. In our meta‐analysis, both the positive and negative likelihood ratio and post‐test probability were moderate. Given a pretest probability of 50%, the positive post‐test probability is 77% and the negative post‐test probability is 14%.