Accuracy of MRI in detecting seminal vesicle invasion in prostate cancer: a systematic review and meta-analysis.

IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY BJU International Pub Date : 2024-10-22 DOI:10.1111/bju.16547
Thomas Li, Petra L Graham, Brooke Cao, Sunny Nalavenkata, Manish I Patel, Lawrence Kim
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Abstract

Objective: To determine the diagnostic test accuracy of multiparametric magnetic resonance imaging (mpMRI) in detecting seminal vesicle invasion (SVI).

Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, the Excerpta Medica dataBASE (EMBASE) and Cochrane databases were search up to May 2023. We included studies that investigated the accuracy of mpMRI in detecting SVI when compared to radical prostatectomy specimens as the reference standard. Data extraction was performed by two independent reviewers to construct 2 × 2 tables, as well as patient and study characteristics. The methodological quality of the included studies was assessed with the Quality of Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and presented graphically with summary receiver operator characteristic (SROC) plots.

Results: A total of 27 articles with 4862 patients were included for analysis. The summary sensitivity and specificity were 0.57 (95% confidence interval [CI] 0.45-0.68) and 0.95 (95% CI 0.92-0.99), respectively. Meta-regression indicated that there was no evidence that coil strength (P = 0.079), coil type (P = 0.589), year of publication (P = 0.503) or use of the Prostate Imaging-Reporting and Data System (P = 0.873) significantly influenced these results. The summary diagnostic odds ratio was 28.3 (95% CI 15.0-48.8) and the area under the curve for the SROC curve was 0.87. The I2 statistic was a modest 11.9%. In general, methodological quality was good.

Conclusion: The use of mpMRI in detecting SVI has excellent specificity but poor sensitivity. Both endorectal coils and magnetic field strength do not significantly impact the accuracy of MRI. These findings suggest that mpMRI cannot reliably rule out SVI in patients with prostate cancer.

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磁共振成像检测前列腺癌精囊侵犯的准确性:系统回顾和荟萃分析。
目的确定多参数磁共振成像(mpMRI)在检测精囊受侵(SVI)方面的诊断准确性:检索医学文献分析和检索系统在线(MEDLINE)、PubMed、Excerpta Medica dataBASE(EMBASE)和 Cochrane 数据库,检索时间截至 2023 年 5 月。我们纳入了调查 mpMRI 与作为参考标准的根治性前列腺切除术标本相比在检测 SVI 方面准确性的研究。数据提取由两名独立审稿人完成,以构建 2 × 2 表格,并记录患者和研究的特征。纳入研究的方法学质量采用诊断准确性研究质量评估工具(Quality of Assessment of Diagnostic Accuracy Studies-2)进行评估。对敏感性和特异性进行了汇总,并用受体运算特征汇总图(SROC)进行了图解:共有 27 篇文章、4862 名患者被纳入分析。汇总的敏感性和特异性分别为 0.57(95% 置信区间 [CI] 0.45-0.68)和 0.95(95% CI 0.92-0.99)。元回归表明,没有证据表明线圈强度(P = 0.079)、线圈类型(P = 0.589)、发表年份(P = 0.503)或前列腺成像报告和数据系统的使用(P = 0.873)对上述结果有显著影响。诊断几率比为 28.3 (95% CI 15.0-48.8),SROC 曲线下面积为 0.87。I2 统计量仅为 11.9%。总体而言,研究方法质量良好:结论:使用 mpMRI 检测 SVI 具有极佳的特异性,但敏感性较差。肛门直肠内线圈和磁场强度对磁共振成像的准确性没有明显影响。这些发现表明,mpMRI 无法可靠地排除前列腺癌患者的 SVI。
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来源期刊
BJU International
BJU International 医学-泌尿学与肾脏学
CiteScore
9.10
自引率
4.40%
发文量
262
审稿时长
1 months
期刊介绍: BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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