Background/Aim: Axillary lymph node (ALN) status plays a key role in the staging of breast cancer. Positron Emission Tomography/Computed Tomography (PET/CT) using 18-Fluorodeoxyglucose (18FDG) can visualise ALN metastasis. However, its utility compared to current methods is unclear. We systematically reviewed the role of 18FDG PET/CT in breast cancer staging. Materials and Methods: PubMed, Ovid and Cochrane were searched systematically up until August 2020. Included papers had true positive (TP), false positive (FP), true negative (TN) and false negative (FN) rates, sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV). Results: Nine studies (n=1486) were included, showing: i) sensitivity=52.2%, ii) specificity=91.6%, iii) PPV=77.8%, iv) NPV=77.2, and v) accuracy=77.3%. Conclusion: 18FDG-PET/CT has a low sensitivity but high specificity for ALN disease. Therefore, ultrasound-guided biopsy could be considered in a positive CT/PET. Modest accuracy prohibits the use of 18FDG-PET/CT alone in axillary staging. Prospective research using standardised protocols and quantitative cut-off points is warranted.

中文翻译：

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PET/CT 对 I-III 期癌症患者腋窝分期的敏感性、特异性和诊断准确性：文献系统回顾

背景/目的：腋窝淋巴结 (ALN) 状态在乳腺癌分期中起着关键作用。使用 18-氟脱氧葡萄糖 (18FDG) 的正电子发射断层扫描/计算机断层扫描 (PET/CT) 可以可视化 ALN 转移。然而，与当前方法相比，它的效用尚不清楚。我们系统地回顾了 18FDG PET/CT 在乳腺癌分期中的作用。材料和方法：系统检索了 PubMed、Ovid 和 Cochrane，直​​至 2020 年 8 月。包括的论文具有真阳性 (TP)、假阳性 (FP)、真阴性 (TN) 和假阴性 (FN) 率、敏感性、特异性、准确性、阳性 (PPV) 和阴性预测值 (NPV)。结果：纳入了 9 项研究 (n=1486)，显示：i) 敏感性=52.2%，ii) 特异性=91.6%，iii) PPV=77.8%，iv) NPV=77.2，以及 v) 准确度=77.3%。结论：18FDG-PET/CT 对 ALN 疾病敏感性低但特异性高。因此，在阳性 CT/PET 中可以考虑超声引导活检。适度的准确性禁止在腋窝分期中单独使用 18FDG-PET/CT。使用标准化协议和定量截止点的前瞻性研究是有必要的。