contrast-enhanced magnetic resonance imaging (DCE-MRI) in the prediction of neoadjuvant chemotherapy response in breast cancer: A Meta-Analysis

Background: The Breast dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) is utilized for screening breast cancer (BC) in women with a total lifetime BC risk of greater than 20-25%. This study aimed to assess the DCE-MRI value in predicting response to neoadjuvant chemotherapy (NAC) in BC patients. Materials and Methods:  International databases, including Medline, PubMed, Embase, and Science Direct, were searched with appropriate keywords. Using the binomial distribution formula, the variance of each study was calculated, and the data were analyzed using Stata 14. Finally, the results of the studies were inputted into the random-effect meta-analysis. Results: Sixteen studies, with no recognized publication bias by Begg’s test, comprising 1868 patients were involved in this study. The sensitivity of DCE-MRI was 0.693, whereas its specificity was 0.754, with 95% confidence intervals (CI) of 0.560-0.826 and 0.605-0.903, respectively. Based on the random-effect model, the results revealed a pooled positive and negative predictive value of 0.458 and 0.901, with 95% CI of 0.339-0.577 and 0.829-0.972, respectively. The pooled DCE-MRI accuracy in predicting pathologic complete response to NAC was 0.768 (95% CI: 0.720-0.817). Finally, a meta-analysis of 10 reports, revealed a pooled AUC 0.779 (95% CI: 0.702-0.856). Conclusion: Overall, the findings of our study revealed that the DCE-MRI is a sensitive and specific method with an acceptable NPV for predicting response to NAC in BC cases