Comparing the diagnostic efficacy of [18F]FDG PET/CT and [18F]FDG PET/MRI for detecting bone metastases in breast cancer: a meta-analysis

Abstract Background This meta-analysis aimed to evaluate the comparative diagnostic efficacy of [ 18 F]FDG PET/CT and [ 18 F] FDG PET/MRI in detecting bone metastases in breast cancer patients. Methods An extensive search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases to identify available publications up to February 2023. Studies were included if they evaluated the diagnostic efficacy of [ 18 F]FDG PET/CT and [ 18 F]FDG PET/MRI in patients with breast cancer bone metastases. Sensitivity and specificity were assessed using the DerSimonian and Laird method, followed by transformation via the Freeman-Tukey double inverse sine transformation. Results 16 articles (including 4 head-to-head comparison articles) involving 1,261 patients were included in the meta-analysis. The overall sensitivity of [ 18 F]FDG PET/CT in patient-based analysis, lesion-based analysis, and head-to-head comparison were 0.73, 0.89, and 0.87, respectively, while the overall sensitivity of [ 18 F]FDG PET/MRI were 0.99, 0.99, and 0.99. The results indicated that [ 18 F]FDG PET/MRI appears to a higher sensitivity in comparison to [ 18 F]FDG PET/CT(all P < 0.05). In contrast, the overall specificity of [ 18 F]FDG PET/CT in patient-based analysis, lesion-based analysis, and head-to-head comparison were 1.00, 0.99, and 1.00, respectively, while the overall specificity of [ 18 F]FDG PET/MRI were 1.00, 0.99, and 0.98. These results suggested that [ 18 F]FDG PET/CT has a similar level of specificity compared to [ 18 F]FDG PET/MRI. Conclusions Our meta-analysis indicates that [ 18 F]FDG PET/MRI demonstrates superior sensitivity and similar specificity to [ 18 F]FDG PET/CT in detecting bone metastases in breast cancer patients. Further prospective research is required to confirm these findings and assess the clinical application of these techniques.