There are variations in the assessment pathways for women recalled at screening, and the imaging assessment pathway with the best diagnostic outcome is poorly understood. This paper examines the efficacy of five imaging modalities for the assessment of screen-recalled breast lesions.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) strategy was employed to identify studies that assessed the efficacy of imaging modalities in the assessment of lesions recalled at screening from the following eight databases: Medline, Web of Science, Embase, Scopus, Science Direct, PubMed, CINAHL, and Global Health. Search terms included “Breast assessment” AND “Diagnostic Workup” OR “Mammography” AND “Digital Breast tomosynthesis” AND “contrast enhanced mammography and Magnetic Resonance imaging” AND “breast ultrasound”. Studies that examined the performance of digital mammography (DM), digital breast tomosynthesis (DBT), handheld ultrasound (HHUS), contrast-enhanced mammography (CEM), and magnetic resonance imaging (MRI) in screen-recalled lesions were reviewed. Meta-analyses of these studies were conducted using the MetaDisc 2.0 software package.Results:Fifty-four studies met the inclusion criteria and examined between one and three imaging modalities. Pooled results of each imaging modality demonstrated that CEM has the highest sensitivity (95; 95% CI: 90–97) followed by MRI (93; 95% CI: 88–96), DBT (91; 95% CI: 87–94), HHUS (90; 95% CI: 86–93), and DM (85; 95% CI: 78–90). The DBT demonstrated the highest specificity (85; 95% CI: 75–91) followed by DM (77; 95% CI: 66–85), CEM (73; 95% CI: 63–81), MRI (69; 95% CI: 55–81), and HHUS (65; 95% CI: 46–80).Conclusions:The CEM, MRI, DBT, and HHUS demonstrate excellent performance in correctly identifying and classifying cancer lesions referred for diagnostic work-up, but HHUS, MRI, and CEM have a more limited ability to discriminate benign lesions than DBT and DM.
筛查召回女性的评估路径存在差异，且诊断效果最佳的影像学评估路径尚不明确。本研究旨在评估五种影像学检查方法在筛查召回乳腺病变诊断中的效能。 方法：采用系统综述与荟萃分析优先报告条目（PRISMA）策略，从以下八个数据库中检索评估影像学检查方法在筛查召回病变诊断中效能的研究：Medline、Web of Science、Embase、Scopus、Science Direct、PubMed、CINAHL和Global Health。检索词包括“乳腺评估”与“诊断检查”或“乳腺X线摄影”与“数字乳腺断层合成”及“对比增强乳腺X线摄影和磁共振成像”与“乳腺超声”。对探讨数字乳腺X线摄影（DM）、数字乳腺断层合成（DBT）、手持超声（HHUS）、对比增强乳腺X线摄影（CEM）和磁共振成像（MRI）在筛查召回病变中诊断效能的研究进行综述。使用MetaDisc 2.0软件包对这些研究进行荟萃分析。 结果：共54项研究符合纳入标准，涉及一至三种影像学检查方法。各影像学检查方法的汇总结果显示，CEM的敏感性最高（95；95% CI：90–97），其次为MRI（93；95% CI：88–96）、DBT（91；95% CI：87–94）、HHUS（90；95% CI：86–93）和DM（85；95% CI：78–90）。DBT的特异性最高（85；95% CI：75–91），其次为DM（77；95% CI：66–85）、CEM（73；95% CI：63–81）、MRI（69；95% CI：55–81）和HHUS（65；95% CI：46–80）。 结论：CEM、MRI、DBT和HHUS在正确识别和分类需进行诊断检查的癌性病变方面表现出优异性能，但HHUS、MRI和CEM在鉴别良性病变方面的能力较DBT和DM更为有限。
肿瘤(癌症)患者之家