Purpose This meta-analysis evaluates and compares the diagnostic accuracy of 18 FFDG PET/CT and 18 FFDG PET/MRI in detecting breast cancer recurrence. Methods A search was conducted across PubMed, Web of Science, and Embase databases up to June 10, 2025, to identify studies evaluating the diagnostic performance of 18 FFDG PET/CT and/or 18 FFDG PET/MRI in breast cancer recurrence. Sensitivity and specificity were calculated using the DerSimonian and Laird method with Freeman-Tukey double arcsine transformation. The Quality Assessment for Studies of Diagnostic Accuracy-2 (QUADAS-2) guidelines were employed to perform the quality evaluation. Results Seventeen studies involving 1,450 patients were included. At the lesion level, the sensitivity of 18 FFDG PET/CT was 0.97 (95% CI: 0.91–1.00), with a specificity of 0.79 (95% CI: 0.58–0.94). 18 FFDG PET/MRI showed a sensitivity of 0.95 (95% CI: 0.91–0.99) and specificity of 0.87 (95% CI:0.75–0.95). Both modalities demonstrated similar sensitivity ( p = 0.71) and specificity ( p = 0.66). At the patient level, the sensitivity of 18 FFDG PET/CT was 0.93 (95% CI: 0.88–0.96), with a specificity of 0.87 (95% CI: 0.80–0.93). 18 FFDG PET/MRI showed a sensitivity of 0.99 (95% CI: 0.94–1.00) and specificity of 0.98 (95% CI, 0.90–1.00). Both modalities demonstrated similar sensitivity ( p = 0.07) and specificity ( p = 0.06). Conclusion 18 FFDG PET/CT and 18 FFDG PET/MRI exhibit comparable sensitivity and specificity in detecting breast cancer recurrence at both the lesion and patient levels. However, high heterogeneity warrants further head-to-head studies to strengthen the evidence and provide more comprehensive insights.
Liu et al. (Fri,) studied this question.