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Published online before print November 16, 2007, 10.1148/radiol.2461061298
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(Radiology 2008;246:116-124.)
© RSNA, 2007

Evidence-based Practice

Meta-Analysis of MR Imaging in the Diagnosis of Breast Lesions1

Nicky H. G. M. Peters, MD, Inne H. M. Borel Rinkes, MD, PhD, Nicolaas P. A. Zuithoff, MSc, Willem P. T. M. Mali, MD, PhD, Karel G. M. Moons, MSc, PhD, and Petra H. M. Peeters, MD, PhD

1 From the Department of Radiology (N.H.G.M.P., W.P.T.M.M.); Department of Surgical Oncology (I.H.M.B.R.); and Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care (N.H.G.M.P., N.P.A.Z., K.G.M.M., P.H.M.P.), University Medical Center Utrecht, Heidelberglaan 100, E01.132, 3584 CX Utrecht, the Netherlands. Received July 28, 2006; revision requested October 3; revision received December 21; accepted January 30, 2007; final version accepted June 1. Address correspondence to N.H.G.M.P. (e-mail: n.peters{at}umcutrecht.nl).

Purpose: To determine, in a meta-analysis, the diagnostic performance of contrast material–enhanced magnetic resonance (MR) imaging in patients with breast lesions.

Materials and Methods: Studies to assess the diagnostic performance of MR imaging in patients suspected of having breast cancer who underwent MR imaging and biopsy from January 1985 through March 2005 were reviewed for inclusion. A summary receiver operating characteristic curve was constructed, and pooled weighted estimates of sensitivity and specificity were calculated by using the recently developed bivariate approach for diagnostic meta-analysis.

Results: Of 251 eligible studies, 44 were included in the meta-analysis (sample size range, 14–821; cancer prevalence, 23%–84%). Pooled weighted estimates of sensitivity and specificity were 0.90 (95% confidence interval: 0.88, 0.92) and 0.72 (95% confidence interval: 0.67, 0.77), respectively. The performance of breast MR imaging was influenced by the prevalence of cancer in the studied population (P = .05) and by whether two criteria (ie, morphology, enhancement, and kinetic enhancement pattern)—versus one or three criteria—were used to differentiate benign from malignant lesions (P = .02).

Conclusion: MR imaging of the breast has high sensitivity and lower specificity in the evaluation of breast lesions.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2461061298/DC1

© RSNA, 2007