A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk.


Journal

Prostate cancer and prostatic diseases
ISSN: 1476-5608
Titre abrégé: Prostate Cancer Prostatic Dis
Pays: England
ID NLM: 9815755

Informations de publication

Date de publication:
09 2021
Historique:
received: 06 08 2020
accepted: 19 10 2020
revised: 14 10 2020
pubmed: 22 11 2020
medline: 2 2 2022
entrez: 21 11 2020
Statut: ppublish

Résumé

Multiparametric magnetic resonance imaging (mpMRI), the use of three multiple imaging sequences, typically T2-weighted, diffusion weighted (DWI) and dynamic contrast enhanced (DCE) images, has a high sensitivity and specificity for detecting significant cancer. Current guidance now recommends its use prior to biopsy. However, the impact of DCE is currently under debate regarding test accuracy. Biparametric MRI (bpMRI), using only T2 and DWI has been proposed as a viable alternative. We conducted a contemporary systematic review and meta-analysis to further examine the diagnostic performance of bpMRI in the diagnosis of any and clinically significant prostate cancer. A systematic review of the literature from 01/01/2017 to 06/07/2019 was performed by two independent reviewers using predefined search criteria. The index test was biparametric MRI and the reference standard whole-mount prostatectomy or prostate biopsy. Quality of included studies was assessed by the QUADAS-2 tool. Statistical analysis included pooled diagnostic performance (sensitivity; specificity; AUC), meta-regression of possible covariates and head-to-head comparisons of bpMRI and mpMRI where both were performed in the same study. Forty-four articles were included in the analysis. The pooled sensitivity for any cancer detection was 0.84 (95% CI, 0.80-0.88), specificity 0.75 (95% CI, 0.68-0.81) for bpMRI. The summary ROC curve yielded a high AUC value (AUC = 0.86). The pooled sensitivity for clinically significant prostate cancer was 0.87 (95% CI, 0.78-0.93), specificity 0.72 (95% CI, 0.56-0.84) and the AUC value was 0.87. Meta-regression analysis revealed no difference in the pooled diagnostic estimates between bpMRI and mpMRI. This meta-analysis on contemporary studies shows that bpMRI offers comparable test accuracies to mpMRI in detecting prostate cancer. These data are broadly supportive of the bpMRI approach but heterogeneity does not allow definitive recommendations to be made. There is a need for prospective multicentre studies of bpMRI in biopsy naïve men.

Identifiants

pubmed: 33219368
doi: 10.1038/s41391-020-00298-w
pii: 10.1038/s41391-020-00298-w
doi:

Substances chimiques

Contrast Media 0

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

596-611

Subventions

Organisme : Wellcome Trust
ID : 204998/Z/16/Z
Pays : United Kingdom

Informations de copyright

© 2020. Crown.

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Auteurs

E J Bass (EJ)

Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK. ebass@ic.ac.uk.
Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK. ebass@ic.ac.uk.

A Pantovic (A)

Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, Belgrade, Serbia.

M Connor (M)

Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK.

R Gabe (R)

Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.

A R Padhani (AR)

Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, London, UK.

A Rockall (A)

Division of Cancer, Department of Surgery and Cancer,Faculty of Medicine, Imperial College London, London, UK.

H Sokhi (H)

Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, London, UK.
Department of Radiology, Hillingdon Hospitals NHS Foundation Trust, London, UK.

H Tam (H)

Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Department of Radiology, Imperial College Healthcare NHS Trust, London, UK.

M Winkler (M)

Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK.

H U Ahmed (HU)

Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Imperial Urology, Division of Cancer, Cardiovascular Medicine and Surgery, Imperial College Healthcare NHS Trust, London, UK.

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