LAUSR

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. Methods A total of 18 studies were included in the review. Sensitivity, specificity, and other important parameters of CESM accuracy for breast cancer diagnosis were pooled and analyzed using random‐effects models. Summary receiver operating characteristic curves were calculated for overall accuracy estimation. Results The summary estimates for CESM in the diagnosis of breast cancer were as follows: the pooled sensitivity and specificity were 0.89 (95% confidence interval [CI], 0.88‐0.91) and 0.84 (95% CI, 0.82‐0.85), respectively. Positive likelihood ratio was 3.73 (95% CI, 2.68‐5.20), negative likelihood ratio was 0.10 (95% CI, 0.06‐0.15), and diagnostic odds ratio was 71.36 (95% CI, 36.28‐140.39). The area under the curve was 0.96 (standard error = 0.011). Conclusion CESM has a high diagnostic accuracy for evaluating breast cancer and can be considered as a useful test for initial assessment of breast lesions. Micro‐Abstract A new meta‐analysis review is needed to evaluate the diagnostic value of contrast‐enhanced spectral mammography (CESM). Eighteen studies were included in the review. The important parameters of CESM accuracy for breast cancer diagnosis were analyzed. CESM can be considered as a useful triage test for initial assessment of breast lesions.