超声和X线钼靶在乳腺癌诊断中的应用价值

目的探讨超声和X线钼靶在乳腺癌诊断中的应用价值。方法选取2011年1月至2014年1月间收治的100例乳腺癌患者,均经手术病理证实。对所有患者的超声和X线钼靶诊断资料进行回顾性分析,比较两种方法诊断乳腺癌的敏感度。结果超声诊断乳腺癌的敏感度为86.0%,X线钼靶诊断乳腺癌的敏感度为75.0%,两种方法的敏感度差异无统计学意义(P>0.05)。两种方法联合诊断敏感度为93.0%,明显大于单独检测,差异有统计学意义(P<0.05)。结论联合应用超声和X线钼靶诊断乳腺癌具有较高的临床应用价值。     

外周血循环miRNA诊断卵巢癌的Meta分析

目的 综合评价外周血循环微小RNA(microRNA,miRNA)对卵巢癌的诊断价值.方法 全面检索PubMed、The Cochrane Library、ISIWeb of Science、CNKI、万方和维普数据库,按照纳入与排除标准收集从各数据库建库至2015年5月发表的关于运用外周血循环miRNA表达水平诊断卵巢癌的文献,应用Meta-DiSc 1.4软件进行Meta分析.结果 共9项关于外周血循环miRNA诊断卵巢癌的研究纳入本次分析,共1 068例研究对象.Meta分析结果显示,外周血循环miRNA诊断卵巢癌的合并敏感度和合并特异性分别为0.74(95％ CI:0.71～0.78)和0.76(95％ CI:0.72 ～0.80),合并诊断阳性似然比和阴性似然比分别为3.03(95％ CI:2.17 ～4.21)和0.32(95％CI:0.25～0.43),合并诊断比值比为10.70(95％ CI:6.82～16.78).总受试者工作特征曲线下面积为0.83,Q*值为0.77.结论 外周血循环miRNA对卵巢癌具有一定的诊断价值.     

超声光散射成像技术在乳腺癌诊断中的应用价值

目的:应用超声光散射成像技术及彩色多普勒超声,探讨其在乳腺癌诊断中的临床应用价值。方法:选取我院乳腺外科行外科手术治疗的女性患者103例,共156个乳腺包块,术前超声常规检查乳腺包块。彩色多普勒超声探查血流分级情况,同时超声光散射系统测量总血红蛋白浓度。每种方法分别计算准确度、敏感度、特异度、阳性预测值和阴性预测值,对乳腺肿物诊断的准确度进行组间分析。结果:超声光散射成像技术诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为76.9%、89.6%、67.4%、67.4%、89.6%。彩色多普勒超声诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为77.6%、74.6%、79.8%、73.5%、80.7%。超声光散射成像技术联合彩色多普勒超声诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为89.7%、95.5%、85.4%、83.1%、96.2%。DOT联合彩色多普勒超声与单独DOT或单独彩色多普勒超声诊断乳腺疾病的准确度差异有统计学意义。结论:超声光散射成像技术联合应用彩色多普勒超声可提高乳腺癌诊断的准确度,为临床医生早期治疗奠定基础。     

乳腺X线摄影联合超声与MRI对乳腺癌诊断价值的对比研究

目的探讨乳腺X线摄影联合超声与MRI对乳腺癌的诊断价值。 方法回顾性分析2015年4月至2016年12月在河北医科大学第四医院就诊的255例(260个病灶)乳腺疾病患者的X线摄影、超声及MRI诊断资料。以病理诊断为金标准,X线摄影、超声与MRI诊断结果依据BI-RADS分类,4～5类为阳性结果,采用受试者工作特征(ROC)曲线评价两者的诊断效能。采用Kappa检验评价两者诊断乳腺癌与病理诊断的一致性。 结果乳腺X线摄影联合超声诊断乳腺癌的敏感度为98.6%(204/207),特异度为77.4%(41/53),准确率为94.2%(245/260),与病理诊断的一致性非常好(Kappa＝0.810,P<0.001); MRI诊断乳腺癌的敏感度为98.1% (203/207),特异度为66.0%(35/53),准确率为91.5%(238/260),与病理诊断的一致性好(Kappa＝0.711,P<0.001)。乳腺X线摄影联合超声和MRI诊断乳腺癌的ROC曲线下面积分别为0.902(95%CI：0.843～0.961,P<0.001)和0.893(95% CI：0.842～0.945,P<0.001),两者间差异无统计学意义(Z＝0.050,P >0.050)。 结论乳腺X线摄影联合超声与MRI相比,两者诊断价值相当,对乳腺癌的诊断准确率均较高。乳腺X线摄影联合超声由于简便和经济,可作为乳腺癌的首选检查方法,而MRI在乳腺癌术前评估中的作用不可替代。     

CT结肠镜诊断结直肠肿瘤和息肉准确性的系统评价

目的:系统评价CT结肠镜用于结直肠肿瘤和息肉诊断的临床价值。方法:通过计算机检索及手工查阅,全面收集CT结肠镜用于结直肠肿瘤和息肉诊断的中英文文献,按纳入与排除标准筛选文献并提取纳入研究中有关准确度的数据,根据QUADAS条目进行质量评价,采用Me-ta Disc 1.4软件检验研究间的异质性并进行Meta分析。结果:最终纳入英文文献22篇,中文文献0篇。异质性检验结果为Spearman相关系数=0.406,P=0.244,提示阈值效应引起的异质性较小,但是存在其他因素导致的异质性,按随机效应模型进行Meta分析。CTC结肠镜诊断结直肠肿瘤和息肉的敏感度和特异度分别为69%和83%,而且诊断的敏感度和特异度随着肿物大小的增加而增加,分别为62%~81%和90.1%~92.4%。结论:用CT结肠镜诊断结直肠肿瘤和息肉具有很高的特异性,但其敏感度波动范围很大。     

乳腺常规超声与超声造影对早期乳腺癌的诊断价值

目的探讨乳腺常规超声与超声造影对早期乳腺癌的诊断价值。方法选取2016年5月至2019年5月间西安交通大学第二附属医院收治的80例早期乳腺癌患者进行回顾性研究,所有患者分别进行常规超声检查和超声造影检查。分析良恶性乳腺肿瘤的特征,并与穿刺或术后病理结果进行比较,分析两种检测方法的诊断价值。结果超声造影结果提示,乳腺恶性肿瘤主要为不均匀增强及周边增强,乳腺良性肿瘤主要为无增强和均匀增强为主。33例患者经常规超声诊断,良性16例,恶性17例,其中误诊10例(4例误诊为良性,6例误诊为恶性); 47例患者经超声造影诊断,良性12例,恶性35例,其中误诊5例(良性误诊2例、恶性误诊3例)。常规超声诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为64. 7%、75. 0%、73. 3%和66. 7%。超声造影诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为94. 1%、76. 9%、91. 4%和83. 3%。超声造影的敏感度明显高于常规造影,差异有统计学意义(P <0. 05)。结论常规超声联合超声造影可提高早期乳腺癌的诊断敏感度,在早期乳腺癌的诊断以及良恶性肿瘤的鉴别诊断中有重要的临床应用价值。     

超声和X线检查对乳腺病变的诊断效能分析

目的探讨超声和X线检查对乳腺病变的诊断效能。方法回顾性分析2007—2014年在北京市顺义区妇幼保健院乳腺中心就诊的1 083例患者乳腺病变的超声和X线影像诊断资料。根据年龄将患者分为40岁、40~49岁、50~59岁和≥60岁4个组,根据腺体密度将患者分为Ⅰ~Ⅳ度4个组。以病理诊断为金标准,超声和X线BI-RADS分级4~5级为阳性结果,采用受试者工作特征(ROC)曲线对两者诊断效能进行评价。采用Kappa检验评价超声和X线检查单独及联合使用的一致性。结果 1 083例患者均有明确病理诊断,包括乳腺癌386例和良性疾病697例。在386例乳腺癌患者中,超声单独诊断乳腺癌的敏感度和特异度分别为93.0%(359/386)和87.8%(612/697),X线单独诊断乳腺癌的敏感度和特异度分别为76.2%(294/386)和92.4%(644/697),两者联合诊断乳腺癌的敏感度和特异度分别为95.1%(367/386)和82.6%(576/697)。以病理诊断为金标准,超声和X线检查与金标准的一致性检验Kappa值分别为0.782和0.701,联合诊断的Kappa值为0.734(P均0.001)。乳腺超声和X线诊断的ROC曲线下面积分别为0.904(95%CI:0.885~0.921,P0.001)和0.843(95%CI:0.820~0.864,P0.001),超声的诊断价值优于X线(Z=5.930,P0.001)。对于4个年龄组研究对象,超声的诊断价值均优于X线(Z=2.549、5.332、3.584和2.031,P均0.050)。超声和X线对于乳腺腺体分型为Ⅱ度者诊断价值相当(Z=0.178,P=0.859),而超声对腺体分型为Ⅰ度、Ⅲ度和Ⅳ度者的诊断价值均高于X线(Z=2.129、5.847、3.437,P均0.050)。结论超声和X线对乳腺病变均有较好的诊断价值,超声的诊断价值略优于X线。建议临床实践中对于致密型乳腺,在X线检查的基础上结合超声检查,以提高乳腺病变检出率。     

联合检测肿瘤相关抗原抗体在结直肠癌免疫诊断中价值的研究

目的:对多种肿瘤相关抗原 (tumor-associated antigen, TAA) 抗体的联合检测在结直肠癌(colorectal cancer , CRC)早期诊断中的价值进行评价,从而寻找一种真实可靠的CRC早期诊断方法.方法:采用ELISA法对46例CRC患者和58例健康人血清中的15种TAA抗体进行检测,并对检测结果行统计学分析后进行评价.结果:单独检测15种TAA时,大多数指标的敏感度都偏低(最高低于25%);剔除在单个抗体检测评价时没有统计学意义的3个抗体后,12种TAA两两组合后检测抗体阳性率最高可提高到41%,明显高于单个抗体的检测结果;对12种TAA进行不同的组合,逐渐增加抗原数目进行检测时,随着检测抗体的增多,诊断的敏感度随之增加,12种抗体联合检测的敏感度达到80.4%,特异度达82.8%,阳性预测值为78.7%,阴性预测值为84.2%.阳性似然比为5.81,阴性似然比为0.24,说明12种TAA检测CRC的临床价值较高,Kappa值为0.63,提示该实验诊断结果与真实值之间中度一致.结论:联合检测多种TAA抗体在CRC的早期诊断中具有一定的应用价值,从而为建立CRC早期体外非侵入性诊断技术的研究奠定了基础.     

应用三维超声重建成像诊断乳腺癌

背景与目的：评价三维超声重建成像在乳腺癌诊断中的应用价值。材料与方法：采用LOGIQ 7型彩色超声诊断仪。对经病理证实的48例乳腺癌患者进行二维及一维超声成像检查。结果：三维超声重建成像对乳腺癌肿块周边浸润层次、彩色血流分布情况等,明显高于二维超声检查。三维超声重建成像显示乳腺癌肿块大小形态,与皮肤、胸肌、胸壁等周边组织关系较明确,对乳腺癌血流分布情况显示清晰。结论：三维超声重建成像能更充分地表现肿瘤的形态结构、毗邻关系及血流分布情况,有助于乳腺癌诊断和临床评估。     

钼靶X线在亚洲女性乳腺癌筛查中的准确性评价

目的 评价在亚洲人群乳腺癌筛查中使用钼靶X线诊断乳腺癌的准确性.方法 2002年3月至2007年9月,收集8718名常规体检的成都市社区女性的乳腺钼靶X线检查资料,分别以病理组织学结果和随访结果为最终诊断的金标准,计算钼靶X线诊断乳腺癌的敏感度和特异度.检索国内外有关钼靶X线用于亚洲女性一般人群乳腺癌筛查的研究,连同上述队列资料一起纳入Meta分析,计算合并敏感度、特异度及诊断比值比(DOR),并绘制综合受试者工作特征曲线(SROC),评价其诊断效能.结果 基于成都社区的随访研究显示,钼靶x线诊断乳腺癌的敏感度为0.889(95%CI为0.741～0.970),特异度为0.991(95%CI为0.987～0.993).Meta分析共纳入合格研究7个,共计研究对象223 619人.纳入的研究具有异质性,按照随机效应模型(REM)计算出的合并敏感度为0.845(95%CI为0.821～0.870),特异度为0.930(95%CI为0.929～0.931),DOR为117.271(95%CI为65.060～211.412),SROC下面积为0.9144.结论 钼靶X线在亚洲女性乳腺癌筛查中有较高的准确性.     

Diagnostic Value of Contrast-Enhanced Spectral Mammography for Screening Breast Cancer: Systematic Review and Meta-analysis

Background

Contrast-enhanced spectral mammography (CESM) is a new image examination technology that has developed over the past few years. As CESM technology keeps improving, a current meta-analysis review is needed to systematically evaluate the potential diagnostic value of CESM.

Sensitivity, specificity and predictive values of breast imaging in the detection of cancer.

In an observational follow-up study we determined whether the combined use of mammography and breast ultrasonography is an appropriate diagnostic tool to select patients with symptomatic breast disease who need additional pathological evaluation. Mammography and ultrasound were used as complementary diagnostic modalities in 3014 consecutively referred and mainly symptomatic patients. Sensitivity, specificity, predictive values and likelihood ratios were calculated according to standard procedures. Virtually complete follow-up was obtained by correlating the radiological diagnosis with clinical records, final pathological findings, records from the Cancer Register and data from questionnaires sent to the general practitioners of all the referred patients. After an average follow-up period of 30 months, the sensitivity for breast cancer detection was 92.0% and the specificity 97.7%. A positive predictive value of 68.0%, a negative predictive value of 99.6%, a positive likelihood ratio of 40 and a negative likelihood ratio of 0.08 were found. The mean diagnostic delay as a result of false negative examinations was 9 months (range 0-20 months). We conclude that breast imaging in routine daily practice, consisting of the integral use of mammography and ultrasonography, is an appropriate tool in the detection of cancer and should be included in the work-up of symptomatic breast disease.     

影像学检查对卵巢上皮性癌治疗后复发诊断价值的Meta分析

目的 系统评价影像学检查（B 超、CT、MRI、PET/CT）对卵巢上皮性癌治疗后复发的诊断价值。方法 以计算机检索PubMed、Embase、Medline、Cochrane Library、EBMR、CBM、CJFD、CSJD 和清华同方等数据库。检索期限自建库至今,收集有关影像学检查（B 超、CT、MRI、PET/CT）诊断卵巢上皮性癌复发的诊断试验。根据诊断性试验准确性质量评价工具（QUADAS）评价文献质量并提取数据, Meta-Disc 1.4 版软件进行Meta 分析。结果 最终纳入研究的 CT 文献 8 篇,共 478 例患者;MRI 文献 4 篇,共 231 例患者;PET/CT 文献 15 篇,共 1 007 例患者。Meta分析结果显示：CT 检查对卵巢上皮性癌治疗后复发的诊断比值比为10.32（95% CI：4.93～21.62）,敏感性和特异性分别为 70%（95% CI：64%～75%）和 81%（95%CI：75%～86%）,阳性似然比和阴性似然比分别为 3.11（95%CI：2.30～4.19）和 0.35（95% CI：0.23～0.55）。MRI 检查对卵巢上皮性癌治疗后复发的诊断比值比为 55.90（95% CI：19.37～161.36）,敏感性和特异性分别为87%（95%CI：82%～92%）和 90%（95% CI：78%～97%）,阳性似然比和阴性似然比分别为 7.57（95%CI：3.31～17.33） 和 0.15（95% CI：0.06～0.39）。PET/CT 检查对卵巢上皮性癌治疗后复发的诊断比值比为 63.09（95%CI：26.29～151.43）,敏感性和特异性分别为 88%（95% CI：85%～91%）和 88%（95% CI：84%～91%）,阳性似然比和阴性似然比分别为 7.64（95% CI：2.56～22.86）和 0.13（95% CI：0.08～0.22）。结论 CT、MRI、PET/CT 检查在诊断卵巢上皮性癌治疗后复发有较高的敏感性和特异性,而 PET/CT 检查的敏感性高于 MRI 及 CT 检查。     

Diagnostic Accuracy of Ultrasonograph Guided Fine-needle Aspiration Cytologic in Staging of Axillary Lymph Node Metastasis in Breast Cancer Patients: a Meta-analysis

Purpose: To evaluate the diagnostic accuracy of ultrasonograph and fine-needle aspiration cytologicexamination (USG-FNAC) in the staging of axillary lymph node metastasis in breast cancer patients.Methods:We conducted an electronic search of the literature addressing the performance of USG-FNAC in diagnosis ofaxillary lymph node metastasis in databases such as Pubmed, Medline, Embase, Ovid and Cochrane library. Weintroduced a series of diagnostic test indices to evaluate the performance of USG-FNAC by the random effectmodel (REM), including sensitivity, specificity, likelihood ratios, and diagnostic odds ratios and area under thecurve (AUC). Results: A total of 20 studies including 1371 cases and 1289 controls were identified. The pooledsensitivity was determined to be 0.66 (95% CI 0.64-0.69), specificity 0.98 (95% CI 0.98-0.99), positive likelihoodratio 22.7 (95% CI 15.0-34.49), negative likelihood ratio 0.32 (95% CI 0.25-0.41), diagnostic OR 84.2 (95% CI53.3-133.0). Due to the marginal threshold effect found in some indices of diagnostic validity, we used a summarySROC curve to aggregate data, and obtained a symmetrical curve with an AUC of 0.942. Conclusion: The resultsof this meta-analysis indicated that the USG-FNAC techniques have acceptable diagnostic validity indices andcan be used for early staging of axillary lymph node in breast cancer patients.     

Performance of diagnostic mammography for women with signs or symptoms of breast cancer

BACKGROUND: The performance of diagnostic mammography for women with signs or symptoms of breast cancer has not been well studied. We evaluated whether age, breast density, self-reported breast lump, and previous mammography influence the performance of diagnostic mammography. METHODS: From January 1996 through March 1998, prospective diagnostic mammography data from women aged 25-89 years with no previous breast cancer were linked to cancer outcomes data in six mammography registries participating in the Breast Cancer Surveillance Consortium. We used the final mammographic assessment at the end of the imaging work-up to determine abnormal mammographic examination rate, positive predictive value (PPV), sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve. We used age, breast density, prior mammogram, and self-reported breast lump jointly as predictors of performance. All statistical tests were two-sided. RESULTS: Of 41 427 diagnostic mammograms, 6279 (15.2%) were judged abnormal. The overall PPV was 21.8%, sensitivity was 85.8%, and specificity was 87.7%. Multivariate analysis showed that sensitivity and specificity generally declined as breast density increased (P =.007 and P<.001, respectively), that previous mammography decreased sensitivity (odds ratio [OR] = 0.52, 95% confidence interval [CI] = 0.36 to 0.74; P<.001) but increased specificity (OR = 1.43, 95% CI = 1.31 to 1.57; P<.001), and that a self-reported breast lump increased sensitivity (OR = 1.64, 95% CI = 1.13 to 2.38; P =.013) but decreased specificity (OR = 0.54, 95% CI = 0.49 to 0.59; P<.001). ROC analysis showed that higher breast density and previous mammography were negatively related to accuracy (P<.001 for both). CONCLUSIONS: Diagnostic mammography in women with signs or symptoms of breast cancer shows higher sensitivity and lower specificity than screening mammography does. Higher breast density and previous mammographic examination appear to impair performance.     

18F-FDG PET及PET/CT 在食管癌复发转移的诊断与术后慢性炎症鉴别诊断中的应用:Meta分析

目的:系统评价18F-FDG PET及PET/CT 在食管癌治疗后复发转移及术后慢性炎症鉴别诊断中的应用。方法:　系统检索PubMed、EMBASE、Ovid、Web of Science、EBSCO、Cochrane图书馆、万方、维普及中国期刊网（CNKI）数据库,获得符合纳入标准的相关文献。采用诊断试验质量评价标准第二版评价纳入文献质量。采用Meta-disc 1.4软件进行统计分析,得到合并效应量,并绘制汇总受试者工作特征曲线,得到曲线下面积和Q值。采用Stata 14.0软件绘制Deek's漏斗图,对合并文献进行发表偏倚的估计。结果:　共纳入8篇文献,合并的敏感度、特异度、阳性似然比、阴性似然比和诊断比值比分别为0.95（0.92~0.97）、0.75（0.67~0.82）、3.85（2.87~5.16）、0.07（0.04~0.11）和61.18（31.43~119.07）;绘制汇总受试者工作特征曲线后得到曲线下面积和Q值分别为0.95和0.89;Deek's漏斗图未见明显发表偏倚。结论:18F-FDG PET及PET/CT 在食管癌治疗后复发转移的诊断及术后慢性炎症鉴别诊断中有广泛应用。     

Urine BLCA-4 exerts potential role in detecting patients with bladder cancers: a pooled analysis of individual studies

Epidemiological studies have explored the diagnostic effect of urine BLCA-4 in bladder cancer. However, the results remain controversial. Therefore, we conducted this pooled analyses to determine the overall accuracy of urine BLCA-4 in bladder cancer. A comprehensive electronic and hand search was conducted for related literatures though several databases. QUADAS-2 was used to assess the quality of each included studies. Diagnostic parameters were calculated using Meta-Disc (version 1.4) and Stata (version 12.0) software. Nine published articles with 1,119 subjects were included. The summary estimates were: sensitivity 0.93 (95% confidence interval [CI] = 0.90-0.95), specificity 0.97 (95% CI, 0.95-0.98), positive likelihood ratio 48.16 (95% CI, 11.77-197.01), negative likelihood ratio 0.08 (95% CI, 0.06-0.11), diagnostic odds ratio 534.03 (95% CI, 150.15-1899.31), and the AUC was 0.9607. In conclusion, urine BLCA-4 is a promising marker in diagnosing bladder cancer.     

miR-29 家族对恶性肿瘤诊断价值的Meta分析

[摘要] 目的：准确评价微小RNA-29（miRNA-29）对恶性肿瘤的诊断价值。方法：检索3 个英文数据库PubMed、Embase 和Web of Science 以及2 个中文数据库中国知网（CNKI）和万方数据（Wanfang Data）,检索自各数据库建立时间起至2018 年9 月15日miRNA-29 的文献资料,检索词包括miRNA-29（miR-29）、肿瘤、癌、血清、血浆、诊断、tumor、cancer、carcinoma、serum、plasma、diagnosis 等,用诊断准确性研究的质量评价-2（QUADAS-2）工具对纳入文献进行质量控制,用Stata12.0 统计学软件计算合并灵敏度、特异度、阳性似然比、阴性似然比及诊断比值比,采用Meta 回归分析及亚组分析探究异质性来源。结果：从1 172 篇与肿瘤、miR-29 相关的文献中筛选出20 篇文献,其合并灵敏度为0.76（95%CI：0.68~0.83）,合并特异度为0.83（95%CI：0.74~0.89）,合并阳性似然比（PLR）为4.5（95%CI：2.70~7.40）,合并阴性似然比（NLR）为0.28（95%CI：0.20~0.41）,诊断优势比（DOR）为16（95%CI：7~35）,受试者工作特征曲线下面积（AUC）为0.86（95%CI：0.83~0.89）。血浆标本的合并特异度显著高于血清标本（P<0.01）。miR-29 对乳腺癌、胰腺癌诊断价值较高（DOR=101.52、11.22）,对结直肠癌、非小细胞性肺癌诊断价值较低（DOR=5.05、6.57）;miR-29b 对恶性肿瘤诊断价值较高（DOR=60.91）。未发现显著性发表偏倚（P>0.05）。结论：miR-29 对恶性肿瘤有良好的灵敏度与特异度,具有潜在的诊断价值。     

Accuracy of quantitative ultrasound elastography for differentiation of malignant and benign breast abnormalities: a meta-analysis

The purpose of this study was to systematically review recent literature on diagnostic performance of strain ratio and length ratio, two different strain measurements in ultrasound elastography, for differentiating benign and malignant breast masses. A literature search of PubMed and other medical and general purpose databases from inception through January 2012 was conducted. Published studies that evaluated the diagnostic performance of ultrasound elastography alone reporting either strain ratio or length ratio for characterization of focal breast lesions and using cytology (fine needle aspiration) or histology (core biopsy) as a reference standard were included. Summary diagnostic performance measures were assessed using bivariate generalized linear mixed modeling. Nine studies reported strain ratio for 2,087 breast masses (667 cancers, 1,420 benign lesions). Summary sensitivity and specificity were 88 % (95 % Credible Interval (CrI), 84-91 %), and 83 % (95 % CrI, 78-88 %), respectively. The positive and negative likelihood ratios (LR) were 5.57 (95 % CrI, 3.85-8.01) and 0.14 (95 % CrI, 0.09-0.20), respectively. The inconsistency index for heterogeneity was 6 % (95 % CrI, 1-22 %) for sensitivity and 8 % (95 % CrI, 3-24 %) for specificity. Analysis of three studies reporting length ratio for 450 breast masses demonstrated sensitivity and specificity of 98 % (95 % CrI, 93-99 %) and 72 % (95 % CrI, 31-96 %), respectively. Strain ratio and length ratio have good diagnostic performance for distinguishing benign from malignant breast masses. Although, this performance may not be incrementally superior to that of breast imaging reporting and data system (BIRADS) in B-mode ultrasound, the application of USE using strain ratio or length ratio in combination with USB may have the potential to benefit the patients, and this requires further comparative effectiveness and cost-effectiveness analyses.