Accuracy of CEUS-guided sentinel lymph node biopsy in early-stage breast cancer: a study review and meta-analysis

• Published in: World journal of surgical oncology Vol. 18; no. 1; pp. 112 - 11
• Main Authors: Cui, Qiuxia, Dai, Li, Li, Jialu, Xue, Jialei
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.05.2020; BioMed Central; BMC
• Subjects: Accuracy; Axilla; Biopsy; Breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Care and treatment; Contrast agents; Contrast Media - administration & dosage; Contrast-enhanced ultrasound; Diagnosis; Diagnostic accuracy; Diagnostic systems; Evaluation; Feasibility Studies; Female; Health risks; Humans; Identification; Image-Guided Biopsy - methods; Image-Guided Biopsy - statistics & numerical data; Isotopes; Localization; Lymph node biopsy; Lymph nodes; Lymphatic Metastasis - diagnosis; Lymphatic Metastasis - pathology; Lymphatic system; Mastectomy; Meta-analysis; Metastases; Metastasis; Methods; Microbubble; Neoplasm Staging; Patients; Preoperative Care - methods; Preoperative Care - statistics & numerical data; Prognosis; Quality assessment; Quality control; Review; Sensitivity and Specificity; Sentinel lymph node; Sentinel Lymph Node - diagnostic imaging; Sentinel Lymph Node - pathology; Sentinel lymph node biopsy; Sentinel Lymph Node Biopsy - methods; Sentinel Lymph Node Biopsy - statistics & numerical data; Studies; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Ultrasound imaging; China; Microbubble; Contrast-enhanced ultrasound; Sentinel lymph node; Diagnostic accuracy; Sentinel lymph node biopsy; Breast cancer; Review; Meta-analysis
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-020-01890-z

To investigate whether preoperative localization of sentinel lymph node (SLN) by contrast-enhanced ultrasound (CEUS) can further improve the accuracy of sentinel lymph node biopsy (SLNB). Collect published literatures or conference reports by searching electronic databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) evaluation method is used to evaluate the quality of the screened literatures. The pooled risk ratio of cancer metastasis of SLN identified by CEUS (CE-SLN) compared with SLN not identified by CEUS (nonCE-SLN) is calculated, and the pooled diagnostic accuracy of CE-SLN for pathological status of all SLNs is also evaluated. Through search and screening, a total of 16 studies were included, of which five and seven studies, respectively, entered the meta-analysis of metastatic risk ratio and diagnostic accuracy. The localization rate of preoperative CEUS for sentinel lymph nodes was 70 to 100%. The meta-analysis shows that the risk of metastasis of SLN identified by CEUS is significantly higher than that not identified by CEUS, 26.0% vs 4.6%, and risk ratio (RR) is 6.08 (95% CI 4.17-8.85). In early-stage breast cancer, the pathological status of CE-SLN is a good representative of all SLNs, with a pooled sensitivity of 98% (95% CI 0.94-1.00), pooled specificity of 100% (95% CI 0.99-1.00), diagnostic odds ratio (DOR) of 2153.18 (95% CI 476.53-9729.06), and area under the subject receiver operating characteristic (SROC) curve of 0.9968. In early-stage breast cancer, preoperative localization of SLN by CEUS is expected to further improve the accuracy of sentinel lymph node biopsy (SLNB).