Francesco Cantiello1, Giorgio Ivan Russo2, Sascha Kaufmann3, Giovanni Cacciamani4, Fabio Crocerossa1, Matteo Ferro5, Ottavio De Cobelli5, Walter Artibani3, Sebastiano Cimino6, Giuseppe Morgia6, Rocco Damiano1, Konstantin Nikolaou3, Nils Kröger7, Arnulf Stenzl8, Jens Bedke8, Stephan Kruck8. 1. Department of Urology, University Magna Graecia of Catanzaro, Catanzaro, Italy. 2. Urology Section, Department of Surgery, University of Catania, Catania, Italy. giorgioivan1987@gmail.com. 3. Department of Urology, Eberhard Karls University of Tuebingen, Tuebingen, Germany. 4. Department of Urology, University of Verona, Verona, Italy. 5. Department of Urology, European Institute of Oncology, Milan, Italy. 6. Urology Section, Department of Surgery, University of Catania, Catania, Italy. 7. Department of Urology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany. 8. Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany.
Abstract
BACKGROUND: The use of multiparametric magnetic resonance imaging (mpMRI) in the setting of patients under active surveillance (AS) is promising. In this systematic-review we aimed to analyse the role of mpMRI in patients under AS. METHODS: A comprehensive literature research for English-language original and review articles, recently published, was carried out using Medline, Scopus and Web of sciences databases until 30 October 2017. The following MeSH terms were used: 'active surveillance', 'prostate cancer', 'multiparametric magnetic resonance imaging'. A diagnostic meta-analysis was performed for 3.0 T mpMRI in predicting disease re-classification. RESULTS: In total, 226 studies were selected after research and after removal of duplicates. After analysis on inclusion criteria, 43 studies were identified as eligible for this systematic review with a total of 6,605 patients. The timing of MRI during follow-up of AS differed from all studies like criteria for inclusion in the AS protocol. Overall, there was a low risk of bias across all studies. The diagnostic meta-analysis for 1.5 tesla showed a sensitivity of 0.60, negative predictive value (NPV) of 0.75 and a hierarchical summary receiving operating curve (HSROC) of 0.74 while for 3.0 tesla mpMRI a sensitivity of 0.81, a NPV of 0.78 and a HSROC of 0.83. CONCLUSIONS: Overall, the available evidence suggests that both 1.5 or 3.0 Tesla mpMRI are a valid tool to monitor progression during AS follow-up, showing good accuracy capabilities in detecting PCa re-classification. However, the modality to better define what means 'disease progression' on mpMRI must be further evaluated.
BACKGROUND: The use of multiparametric magnetic resonance imaging (mpMRI) in the setting of patients under active surveillance (AS) is promising. In this systematic-review we aimed to analyse the role of mpMRI in patients under AS. METHODS: A comprehensive literature research for English-language original and review articles, recently published, was carried out using Medline, Scopus and Web of sciences databases until 30 October 2017. The following MeSH terms were used: 'active surveillance', 'prostate cancer', 'multiparametric magnetic resonance imaging'. A diagnostic meta-analysis was performed for 3.0 T mpMRI in predicting disease re-classification. RESULTS: In total, 226 studies were selected after research and after removal of duplicates. After analysis on inclusion criteria, 43 studies were identified as eligible for this systematic review with a total of 6,605 patients. The timing of MRI during follow-up of AS differed from all studies like criteria for inclusion in the AS protocol. Overall, there was a low risk of bias across all studies. The diagnostic meta-analysis for 1.5 tesla showed a sensitivity of 0.60, negative predictive value (NPV) of 0.75 and a hierarchical summary receiving operating curve (HSROC) of 0.74 while for 3.0 tesla mpMRI a sensitivity of 0.81, a NPV of 0.78 and a HSROC of 0.83. CONCLUSIONS: Overall, the available evidence suggests that both 1.5 or 3.0 Tesla mpMRI are a valid tool to monitor progression during AS follow-up, showing good accuracy capabilities in detecting PCa re-classification. However, the modality to better define what means 'disease progression' on mpMRI must be further evaluated.
Authors: Vasilis Stavrinides; Francesco Giganti; Bruce Trock; Shonit Punwani; Clare Allen; Alex Kirkham; Alex Freeman; Aiman Haider; Rhys Ball; Neil McCartan; Hayley Whitaker; Clement Orczyk; Mark Emberton; Caroline M Moore Journal: Eur Urol Date: 2020-04-30 Impact factor: 20.096
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