• Yewu Wang, Yumei Jin, Mou Li, Jun Zhang, Shaoyu Wang, Huapeng Zhang, and Bin Song.
• Department of Joint and Sports Medicine, Qujing First People's Hospital, Qujing, Yunan Province, China.
• Medicine (Baltimore). 2022 Nov 4; 101 (44): e31574e31574.

BackgroundThis meta-analysis aimed to explore the diagnostic value of diffusion kurtosis imaging (DKI) compared to mono-exponential diffusion weighted imaging (DWI) in the diagnosis of breast cancer.MethodsA systematic electronic literature search (up to September 2020) was conducted for published English-language studies comparing the diagnostic values of DKI and DWI for the detection of breast cancer. The data of mean kurtosis (MK), mean diffusivity (MD), and apparent diffusion coefficient (ADC) were extracted to construct 2 × 2 contingency tables. The pooled sensitivities, specificities, and areas under the receiver operating characteristic curve (AUCs) were compared between DKI and DWI in the diagnosis of breast cancer.ResultsEight studies were finally included, with a total of 771 patients in the same population. Pooled sensitivities were 82.0% [95% confidence interval (95% CI), 78.2-85.3%] for ADC, 87.3% (95% CI, 83.9-90.1%) for MK, and 83.9% (95% CI, 80.2-87.1%) for MD. Pooled specificities were 81.1% (95% CI, 76.7-84.9%) for ADC, 85.1% (95% CI, 81.1-88.5%) for MK, and 83.2% (95% CI, 79.0-86.8%) for MD. According to the summary receiver operator characteristic curve analyses, the AUCwas 0.901 for ADC, 0.930 for MK, and 0.918 for MD (ADC vs MK, P = .353; ADC vs MD, P = .611). No notable publication bias was found, while significant heterogeneity was observed.ConclusionsAlthough DKI is feasible for identifying breast cancer, MD and MK offer similar diagnostic performance to ADC values. Thus, we recommend that DKI should not be included in the routine evaluation of breast lesions now.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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