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Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis

Background: Studies have shown inconsistent results regarding the diagnostic performance of ultrasound elastography for axillary lymph node metastasis (ALNM) in breast cancer. This meta-analysis aimed to estimate the diagnostic performance of ultrasound elastography (divided into quantitative and qu...

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Autores principales: Huang, Xiao-wen, Huang, Qing-xiu, Huang, Hui, Cheng, Mei-qing, Tong, Wen-juan, Xian, Meng-fei, Liang, Jin-yu, Wang, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593678/
https://www.ncbi.nlm.nih.gov/pubmed/33178580
http://dx.doi.org/10.3389/fonc.2020.552177
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author Huang, Xiao-wen
Huang, Qing-xiu
Huang, Hui
Cheng, Mei-qing
Tong, Wen-juan
Xian, Meng-fei
Liang, Jin-yu
Wang, Wei
author_facet Huang, Xiao-wen
Huang, Qing-xiu
Huang, Hui
Cheng, Mei-qing
Tong, Wen-juan
Xian, Meng-fei
Liang, Jin-yu
Wang, Wei
author_sort Huang, Xiao-wen
collection PubMed
description Background: Studies have shown inconsistent results regarding the diagnostic performance of ultrasound elastography for axillary lymph node metastasis (ALNM) in breast cancer. This meta-analysis aimed to estimate the diagnostic performance of ultrasound elastography (divided into quantitative and qualitative elastography) for ALNM in patients with breast cancer. Methods: The PubMed and Embase databases were searched for eligible studies exploring the diagnostic performance of ultrasound elastography for ALNM in patients with breast cancer. The included studies were divided into quantitative and qualitative elastography groups to perform separate meta-analyses. The diagnostic performance was investigated with pooled sensitivity and specificity and diagnostic odds ratio (DOR) using a bivariate mixed-effects regression model. A summary receiver operating characteristic curve was constructed, and the area under the curve (AUC) was calculated. Results: Seven and 11 studies were included in the quantitative and qualitative elastography meta-analyses, respectively. The pooled sensitivity and specificity, DOR, and AUC with their corresponding 95% confidence intervals were 0.82 (0.75, 0.87), 0.88 (0.78, 0.93), 33 (13, 83), and 0.89 (0.86, 0.91), respectively, for quantitative elastography and 0.81 (0.69, 0.89), 0.92 (0.79, 0.97), 46 (12, 181), and 0.92 (0.89, 0.94), respectively, for qualitative elastography. No significant publication bias existed. Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed among studies. Study design, measurement, and reference standard served as potential sources of heterogeneity for quantitative studies, which were measurement and reference standard for qualitative studies. Conclusions: Both quantitative and qualitative elastography seem to be feasible, non-invasive diagnostic tools for ALNM in breast cancer. Nevertheless, the results must be interpreted carefully, paying attention to heterogeneity issues, especially for quantitative elastography studies.
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spelling pubmed-75936782020-11-10 Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis Huang, Xiao-wen Huang, Qing-xiu Huang, Hui Cheng, Mei-qing Tong, Wen-juan Xian, Meng-fei Liang, Jin-yu Wang, Wei Front Oncol Oncology Background: Studies have shown inconsistent results regarding the diagnostic performance of ultrasound elastography for axillary lymph node metastasis (ALNM) in breast cancer. This meta-analysis aimed to estimate the diagnostic performance of ultrasound elastography (divided into quantitative and qualitative elastography) for ALNM in patients with breast cancer. Methods: The PubMed and Embase databases were searched for eligible studies exploring the diagnostic performance of ultrasound elastography for ALNM in patients with breast cancer. The included studies were divided into quantitative and qualitative elastography groups to perform separate meta-analyses. The diagnostic performance was investigated with pooled sensitivity and specificity and diagnostic odds ratio (DOR) using a bivariate mixed-effects regression model. A summary receiver operating characteristic curve was constructed, and the area under the curve (AUC) was calculated. Results: Seven and 11 studies were included in the quantitative and qualitative elastography meta-analyses, respectively. The pooled sensitivity and specificity, DOR, and AUC with their corresponding 95% confidence intervals were 0.82 (0.75, 0.87), 0.88 (0.78, 0.93), 33 (13, 83), and 0.89 (0.86, 0.91), respectively, for quantitative elastography and 0.81 (0.69, 0.89), 0.92 (0.79, 0.97), 46 (12, 181), and 0.92 (0.89, 0.94), respectively, for qualitative elastography. No significant publication bias existed. Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed among studies. Study design, measurement, and reference standard served as potential sources of heterogeneity for quantitative studies, which were measurement and reference standard for qualitative studies. Conclusions: Both quantitative and qualitative elastography seem to be feasible, non-invasive diagnostic tools for ALNM in breast cancer. Nevertheless, the results must be interpreted carefully, paying attention to heterogeneity issues, especially for quantitative elastography studies. Frontiers Media S.A. 2020-10-15 /pmc/articles/PMC7593678/ /pubmed/33178580 http://dx.doi.org/10.3389/fonc.2020.552177 Text en Copyright © 2020 Huang, Huang, Huang, Cheng, Tong, Xian, Liang and Wang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Huang, Xiao-wen
Huang, Qing-xiu
Huang, Hui
Cheng, Mei-qing
Tong, Wen-juan
Xian, Meng-fei
Liang, Jin-yu
Wang, Wei
Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title_full Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title_fullStr Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title_short Diagnostic Performance of Quantitative and Qualitative Elastography for Axillary Lymph Node Metastasis in Breast Cancer: A Systematic Review and Meta-Analysis
title_sort diagnostic performance of quantitative and qualitative elastography for axillary lymph node metastasis in breast cancer: a systematic review and meta-analysis
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593678/
https://www.ncbi.nlm.nih.gov/pubmed/33178580
http://dx.doi.org/10.3389/fonc.2020.552177
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