Diagnostic Performance of MRI Versus Galactography in Women With Pathologic Nipple Discharge: A Systematic Review and Meta-Analysis
| Autor: | Andrea Luparia, Giovanni Di Leo, Luca Alessandro Carbonaro, Federico Ambrogi, Rubina M. Trimboli, Francesco Sardanelli, Nicole Berger |
|---|---|
| Přispěvatelé: | University of Zurich, Berger, Nicole |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
MEDLINE 610 Medicine & health Diagnostic accuracy Breast Neoplasms pathologic nipple discharge 030218 nuclear medicine & medical imaging Nipple discharge 03 medical and health sciences 0302 clinical medicine systematic review Nipple Discharge 2741 Radiology Nuclear Medicine and Imaging Medicine Humans Radiology Nuclear Medicine and imaging breast 10042 Clinic for Diagnostic and Interventional Radiology business.industry Quality assessment General Medicine Magnetic Resonance Imaging galactography Surgery 030220 oncology & carcinogenesis Meta-analysis Female Radiology medicine.symptom Abnormality business MRI Galactography Systematic search Mammography |
| Zdroj: | AJR. American journal of roentgenology. 209(2) |
| ISSN: | 1546-3141 |
| Popis: | The objective of our study was to perform a systematic review of the literature of the diagnostic accuracy of MRI compared with galactography in women with pathologic nipple discharge.A systematic literature search was performed (MEDLINE, Embase, Web of Science) for articles evaluating the diagnostic performance of MRI and galactography in patients with pathologic nipple discharge and with histologic verification or clinical follow-up. Distinction between any abnormality and cancer was made. Two independent readers selected eligible articles published until December 2015. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data analyses were performed using the bivariate model.Ten articles were analyzed for a total of 921 patients. The study quality was high, with a low risk of bias and low concerns regarding applicability. The pooled sensitivity for any abnormality was significantly higher for MRI, with 92% (95% CI, 85-96%), than for galactography, with 69% (95% CI, 59-78%) (p0.001). The pooled specificity was 76% (95% CI, 49-92%) for MRI versus 39% (95% CI, 16-69%) for galactography (p0.001). The pooled sensitivity and specificity for cancer detection were calculated for MRI only and were 92% (95% CI, 74-98%) and 97% (95% CI, 80-100%), respectively.This meta-analysis shows a higher diagnostic performance of MRI compared with that of galactography in the detection of any kind of lesion in patients with pathologic nipple discharge. Moreover, high sensitivity and very high specificity for cancer by MRI could be confirmed in this clinical setting. If mammography and ultrasound are negative, MRI should be preferred over galactography for further evaluation. |
| Databáze: | OpenAIRE |
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