Is biparametric MRI a feasible option for detecting clinically significant prostate cancer?: A systematic review and meta-analysis.

IF 2.4 3区医学 Q3 ONCOLOGY Urologic Oncology-seminars and Original Investigations Pub Date : 2025-01-02 DOI:10.1016/j.urolonc.2024.12.262

Carlos A Garcia-Becerra, Maria I Arias-Gallardo, Veronica Soltero-Molinar, Jesus E Juarez-Garcia, Mariabelen I Rivera-Rocha, Luis F Parra-Camaño, Natalia Garcia-Becerra, Carlos M Garcia-Gutierrez

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Abstract

Background: Multiparametric MRI (Mp-MRI) is a key tool to screen for Prostate Cancer (Pca) and Clinically Significant Prostate Cancer (CsPca). It primarily includes T2-Weighted imaging (T2w), diffusion-weighted imaging (DWI), and Dynamic Contrast-Enhanced imaging (DCE). Despite its improvements in CsPca screening, concerns about the cost-effectiveness of DCE persist due to its associated side effects, increased cost, longer acquisition time, and limitations in patients with poor kidney function. Recent studies have explored Biparametric MRI (Bp-MRI) as an alternative that excludes DCE.

Objectives: The main objective of this study is to compile and evaluate updated results of Bp-MRI as a diagnostic alternative to detect CsPca.

Methods: A systematic review was conducted using PubMed, Central Cochrane, and ClinicalTrialls.gov registry. Inclusion criteria was focused on observational and experimental studies that assessed a direct comparison of Bp-MRI and Mp-MRI for CsPca detection. The primary outcomes included were necessary to create a contingency 2×2 table and CsPca prevalence from each study. The secondary outcomes included were demographic data and imaging protocol features. The statistical analysis used a Bivariate Random-Effect model to estimate the pooled sensitivity, specificity, and area under the curve (AUC). An univariate random-effect model was conducted to estimate the positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies -2 tool.

Results: From 534 articles initially identified, 19 studies met the inclusion criteria with a total of 5075 patients. The pooled sensitivity estimated was 0.89, pooled specificity was 0.73, and AUC was 0.90; these results showed a slight increase compared to previous studies.

Conclusion: The results obtained showed that Bp-MRI is a feasible alternative to detect CsPca, which demonstrates high diagnostic accuracy and avoids the drawbacks associated with DCE.

Registry: This is a sub-analysis of the protocol registered at PROSPERO (CRD42024552125).

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双参数MRI是检测具有临床意义的前列腺癌的可行选择吗？：系统回顾和荟萃分析。

背景：多参数磁共振成像（Mp-MRI）是筛查前列腺癌（Pca）和临床显著性前列腺癌（CsPca）的重要工具。主要包括t2加权成像（T2w）、弥散加权成像（DWI）和动态对比增强成像（DCE）。尽管DCE在CsPca筛查方面有所改进，但由于其相关副作用、成本增加、获得时间较长以及在肾功能不佳患者中的局限性，对DCE成本效益的担忧仍然存在。最近的研究已经探索了双参数MRI （Bp-MRI）作为排除DCE的替代方法。目的：本研究的主要目的是汇编和评估Bp-MRI作为CsPca诊断替代方法的最新结果。方法：使用PubMed、Central Cochrane和clinicaltrials .gov进行系统评价。纳入标准侧重于观察性和实验性研究，评估Bp-MRI和Mp-MRI对CsPca检测的直接比较。纳入的主要结果有必要从每个研究中创建一个应急2×2表和CsPca患病率。次要结局包括人口统计数据和成像方案特征。统计分析采用双变量随机效应模型来估计合并敏感性、特异性和曲线下面积（AUC）。采用单变量随机效应模型估计阳性似然比、阴性似然比和诊断优势比。使用诊断准确性研究质量评估-2工具评估偏倚风险。结果：在最初纳入的534篇文章中，有19篇研究符合纳入标准，共纳入5075名患者。估计合并敏感性为0.89，合并特异性为0.73，AUC为0.90；与之前的研究相比，这些结果略有增加。结论：Bp-MRI是一种可行的检测CsPca的替代方法，具有较高的诊断准确性，避免了DCE的缺点。注册表：这是在PROSPERO （CRD42024552125）注册的协议的子分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.