A meta-analysis of FDG-PET for the evaluation of breast cancer recurrence and metastases

Breast Cancer Res Treat. 2005 Mar;90(2):105-12. doi: 10.1007/s10549-004-3291-7.


Objective: To evaluate the diagnostic performance of 18F-2-deoxy-2-fluoro-D-glucose-positron emission tomography (FDG-PET) in the evaluation of breast cancer recurrence and metastases.

Data sources: Articles published in medical journals during January 1995-June 2004 were identified by a systematic Medline search, supplemented by a manual search of the references listed in original and review articles.

Study selection: Studies that evaluated FDG-PET with a dedicated camera for the diagnosis of breast cancer recurrence or metastases, and reporting sufficient data to permit calculation of sensitivity and specificity, were included in the analysis.

Data extraction: Two reviewers independently reviewed the eligibility and abstracted data regarding the sample population, technical imaging characteristics of FDG-PET, and the number of true positives, true negatives, false positives and false negatives. Differences between readers were resolved by consensus.

Data synthesis: We used meta-analytic methods to estimate the pooled sensitivity, false positive rate, and the maximum joint sensitivity and specificity. Eighteen studies met the inclusion criteria. Sixteen studies included patient-based data, comprising a sample size of 808 subjects, and eight studies included lesion-based data, totaling 1013 lesions. Among the studies with patient-based data, the median sensitivity was 92.7%, and the median specificity was 81.6%. The pooled sensitivity was 90% [95% confidence interval (86.8-93.2)], and the pooled false positive rate was 11% [95% confidence interval (7.8-14.6)], after the exclusion of outliers. The maximum joint sensitivity and specificity, was 88% [95% confidence interval (86.0-90.6)].

Conclusion: These results indicate that FDG-PET is a valuable tool for detecting breast cancer recurrence and metastases.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / secondary
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Neoplasm Metastasis / diagnostic imaging
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals*
  • Sensitivity and Specificity


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18