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This study aimed to systematically evaluate and meta-analyze the comparison of diagnostic accuracy of CBBCT and DBT to characterize breast cancers. Methods: Two independent reviewers identified screening on diagnostic studies from 1 January 2015 to 30 December 2021, with at least reported sensitivity and specificity for both CBBCT and DBT. A univariate pooled meta-analysis was performed using the random-effects model to estimate the sensitivity and specificity while other diagnostic parameters like the area under the ROC curve (AUC), positive likelihood ratio (LR+), and negative likelihood ratio (LR\u2212) were estimated using the bivariate model. Results: The pooled sensitivity specificity, LR+ and LR\u2212 and AUC at 95% confidence interval are 86.7% (80.3\u201391.2), 87.0% (79.9\u201391.8), 6.28 (4.40\u20138.96), 0.17 (0.12\u20130.25) and 0.925 for the 17 included studies in DBT arm, respectively, while, 83.7% (54.6\u201395.7), 71.3% (47.5\u201387.2), 2.71 (1.39\u20135.29), 0.20 (0.04\u20131.05), and 0.831 are the pooled sensitivity specificity, LR+ and LR\u2212 and AUC for the five studies in the CBBCT arm, respectively. Conclusions: Our study demonstrates that DBT shows improved diagnostic performance over CBBCT regarding all estimated diagnostic parameters; with the statistical improvement in the AUC of DBT over CBBCT. The CBBCT might be a useful modality for breast cancer detection, thus we recommend more prospective studies on CBBCT application.<\/jats:p>","DOI":"10.3390\/s22093594","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:30:28Z","timestamp":1652142628000},"page":"3594","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of Diagnostic Test Accuracy of Cone-Beam Breast Computed Tomography and Digital Breast Tomosynthesis for Breast Cancer: A Systematic Review and Meta-Analysis Approach"],"prefix":"10.3390","volume":"22","author":[{"given":"Temitope Emmanuel","family":"Komolafe","sequence":"first","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"},{"name":"School of Biomedical Engineering, ShanghaiTech University, Shanghai 201210, China"},{"name":"Division of Life Sciences and Medicine, School of Biomedical Engineering (Suzhou), University of Science and Technology of China, Hefei 230026, China"}]},{"given":"Cheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6900-0111","authenticated-orcid":false,"given":"Oluwatosin Atinuke","family":"Olagbaju","sequence":"additional","affiliation":[{"name":"Molecular Imaging Research Center, Harbin Medical University, Harbin 150028, China"},{"name":"TOF-PET\/CT\/MR Center, The Fourth Hospital of Harbin Medical University, Harbin 150028, China"}]},{"given":"Gang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]},{"given":"Qiang","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]},{"given":"Jian","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]},{"given":"Xiaodong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"496","DOI":"10.2214\/AJR.08.1017","article-title":"Cone-beam CT for breast imaging: Radiation dose, breast coverage, and image quality","volume":"195","author":"Conover","year":"2010","journal-title":"AJR Am. 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