![Comparing the diagnostic efficacy of [18F]FDG PET/CT and [18F]FDG PET/MRI for detecting bone metastases in breast cancer: a meta-analysis Cover](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/64f61ea32ce00152c914c8eb/cover-image.jpg)
FIGURE 1.
FIGURE 2.
FIGURE 3.
![Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647356844e662f30ba53ab9b/j_raon-2023-0037_fig_003.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251204%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251204T150333Z&X-Amz-Expires=3600&X-Amz-Signature=ef70c4cea425b6ee666ea3d353e361f9e3884f6dbecd6e716b7cb6bf423af587&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
FIGURE 4.
![Forest plot showing the pooled sensitivities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled sensitivity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,10,11,18,19,20,22,23,24,25,26,27](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647356844e662f30ba53ab9b/j_raon-2023-0037_fig_004.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251204%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251204T150333Z&X-Amz-Expires=3600&X-Amz-Signature=b0fd484ac96945ed6d0f60e2fff0c2e7172e91d466b50e25134a7132826fc2af&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
FIGURE 5.
![Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a patient-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,15,17,18,21,23,25](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647356844e662f30ba53ab9b/j_raon-2023-0037_fig_005.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251204%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251204T150333Z&X-Amz-Expires=3600&X-Amz-Signature=32563313ebc0a42336d8a2587d2ee9d218a883502ef67940ae52999344b2dd06&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
FIGURE 6.
![Forest plot showing the pooled specificities of [18F]FDG PET/CT and [18F]FDG PET/MRI in bone metastasis of breast cancer patients on a lesion-based analysis. The plot displays individual study estimates (squares) with corresponding 95% confidence intervals (horizontal lines) and the pooled specificity estimate (diamond) for both modalities. The size of the squares represents the relative weight of each study in the meta-analysis.9,18,19,20,21,23,25,26,27](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647356844e662f30ba53ab9b/j_raon-2023-0037_fig_006.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20251204%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20251204T150333Z&X-Amz-Expires=3600&X-Amz-Signature=bb9b0ea0a285caeb1f8ce392818f4b1e3967584f8331856cfd49b30e7fae5a7d&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Study and patient characteristics of the included studies for [18F]FDG PET/CT
| Author | Year | Type of imaging test | Study characteristics | Patient characteristics | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Country | Study design | Analysis | Reference standard | No. of patients | Clinical indication | Mean/Median age | Previous treatment | |||
| Catalano et al.15 | 2015 | PET/CT | Italy | Retro | PB | Pathology and/or follow-up imaging | 109 | Initial stage and post-treatment stage | Mean ± SD: (58.08 ± 10.7) | Surgery |
| Melsaether et al.10 | 2016 | PET/CT | USA | Pro | LB | Pathology and/or follow-up imaging | 51 | Initial stage and post-treatment stage | Mean(range): 56 (32–76) | Chemotherapy |
| Botsikas et al.9 | 2018 | PET/CT | Switzerland | Pro | PB and LB | Pathology and/or follow-up imaging | 80 | Initial stage and post-treatment stage | Mean ± SD: (48 ± 12.9) | NA |
| Sawicki et al.11 | 2016 | PET/CT | Germany | Pro | LB | Pathology and/or follow-up imaging | 21 | Post-treatment stage | Mean ± SD: (59.4 ±11.5) | NA |
| Balci et al.17 | 2012 | PET/CT | Turkey | Retro | PB | Pathology and/or follow-up imaging | 162 | Initial stage and post-treatment stage | Mean: 50.6 | Surgery |
| Hahn et al.18 | 2011 | PET/CT | Germany | Retro | PB and LB | Follow-up imaging | 29 | Initial stage | Mean (range): 57.5 (35–78) | NA |
| Manohar et al.19 | 2012 | PET/CT | India | Retro | LB | Pathology and/or follow-up imaging | 111 | Post-treatment stage | Mean(range): 52 (22–80) | Surgery |
| Niikura et al.25 | 2011 | PET/CT | Japan | Retro | LB | Pathology and/or follow-up imaging | 225 | Initial stage and post-treatment stage | Mean: 53.4 | Chemotherapy or endocrine therapy |
| Riegger et al.22 | 2012 | PET/CT | Germany | Retro | LB | Pathology and/or follow-up imaging | 106 | Initial stage | Mean ± SD: (57 ± 13) | NA |
| Rager et al.23 | 2018 | PET/CT | Switzerland | Retro | PB and LB | Follow-up imaging | 25 | Initial stage and post-treatment stage | Median(range): 5 (38–82) | NA |
| Demir et al.20 | 2014 | PET/CT | Turkey | Retro | LB | Pathology and/or follow-up imaging | 50 | Post-treatment stage | Mean ± SD: (53.9 ± 12.3) | NA |
| Hansen et al.24 | 2015 | PET/CT | Denmark | Pro | LB | Pathology | 18 | Post-treatment stage | Mean(range): 61.5 (38–76) | Surgery |
| Niikura et al.21 | 2016 | PET/CT | Japan | Pro | PB | Pathology and/or follow-up imaging | 28 | Initial stage and post-treatment stage | Median(range): 59 (31–76) | Surgery |
| Shawky et al.26 | 2016 | PET/CT | Egypt | Pro | LB | Pathology and/or follow-up imaging | 30 | Post-treatment stage | Mean(range): 53.5 (33–73) | Surgery or Chemotherapy or radiotherapy |
| Teke et al.27 | 2020 | PET/CT | Turkey | Retro | LB | Follow-up imaging | 62 | Initial stage | Median(range): 44.5 (8–81) | NO |
Study and patient characteristics of the included studies for [18F]FDG PET/MRI
| Author | Year | Type of imaging test | Study characteristics | Patient characteristics | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Country | Study design | Analysis | Reference standard | No. of patients | Clinical indication | Mean/Median age | Previous treatment | |||
| Catalano et al.15 | 2015 | PET/MRI | Italy | Retro | PB | Pathology and/or follow-up imaging | 109 | Initial stage and post-treatment stage | Mean ± SD: (58.08 ± 10.7) | Surgery |
| Bruckmann et al.21 | 2021 | PET/MRI | Germany | Pro | PB and LB | Pathology | 154 | Post-treatment stage | Mean ± SD: (53.8±11.9) | NO |
| Melsaether et al.10 | 2016 | PET/MRI | USA | Pro | LB | Pathology and/or follow-up imaging | 51 | Initial stage and post-treatment stage | Mean(range): 56(32–76) | Chemotherapy |
| Botsikas et al.9 | 2018 | PET/MRI | Switzerland | Pro | PB and LB | Pathology and/or follow-up imaging | 80 | Initial stage and post-treatment stage | Mean ± SD: (48 ± 12.9) | NA |
| Sawicki et al.11 | 2016 | PET/MRI | Germany | Pro | LB | Pathology and/or follow-up imaging | 21 | Post-treatment stage | Mean ± SD: (59.4 ± 11.5) | NA |