Jing Zeng1, Qingqing Cheng1, Dong Zhang1, Meng Fan1, Changzheng Shi1,2, Liangping Luo1,2. 1. Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. 2. Engineering Research Center of Medical Imaging Artificial Intelligence for Precision Diagnosis and Treatment, Guangzhou, China.
Abstract
BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) now has been used to diagnose prostate cancer (PCa). Equivocal lesions are defined as PIRADS category 3 or a Likert scale of 1 to 5 category 3 lesions. Currently, there are no clear recommendations for the management of these lesions. This study aimed to estimate the diagnostic capacity of DCE-MRI for PCa and clinically significant prostate cancer (csPCa) in equivocal lesions. MATERIALS AND METHODS: Two researchers searched PubMed, Embase and Web of Science to identify studies that met our subject. We searched for articles that mention the accuracy of the diagnosis of DCE-MRI for PCa or csPCa in equivocal lesions and used histopathological results as the reference standard. We used a tool (the Quality Assessment of Diagnostic Accuracy Studies-2 tool) to evaluate the quality of the studies that we screened out. Meta-regression was used to explore the reasons for heterogeneity in results. RESULTS: Ten articles were eventually included in our study. The sensitivity, specificity and 95% confidence intervals (CI) for DCE-MRI in diagnosing csPCa were 0.67 (95% CI, 0.56-0.76), 0.58 (95% CI, 0.46-0.68). The sensitivity and specificity and 95% CI for DCE-MRI in diagnosing PCa were 0.57 (95% CI, 0.46-0.68), 0.58 (95% CI, 0.45-0.70). The areas under the curve (AUC) of DCE-MRI were 0.67 (95% CI, 0.63-0.71) and 0.60 (95% CI, 0.55-0.64) while diagnosing csPCa and PCa. Through meta-regression, we found that study design, magnetic field strength, the definition of csPCa, and the scoring system were the sources of heterogeneity. CONCLUSION: The results of our study indicate that the role of DCE-MRI in equivocal lesions may be limited.
BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) now has been used to diagnose prostate cancer (PCa). Equivocal lesions are defined as PIRADS category 3 or a Likert scale of 1 to 5 category 3 lesions. Currently, there are no clear recommendations for the management of these lesions. This study aimed to estimate the diagnostic capacity of DCE-MRI for PCa and clinically significant prostate cancer (csPCa) in equivocal lesions. MATERIALS AND METHODS: Two researchers searched PubMed, Embase and Web of Science to identify studies that met our subject. We searched for articles that mention the accuracy of the diagnosis of DCE-MRI for PCa or csPCa in equivocal lesions and used histopathological results as the reference standard. We used a tool (the Quality Assessment of Diagnostic Accuracy Studies-2 tool) to evaluate the quality of the studies that we screened out. Meta-regression was used to explore the reasons for heterogeneity in results. RESULTS: Ten articles were eventually included in our study. The sensitivity, specificity and 95% confidence intervals (CI) for DCE-MRI in diagnosing csPCa were 0.67 (95% CI, 0.56-0.76), 0.58 (95% CI, 0.46-0.68). The sensitivity and specificity and 95% CI for DCE-MRI in diagnosing PCa were 0.57 (95% CI, 0.46-0.68), 0.58 (95% CI, 0.45-0.70). The areas under the curve (AUC) of DCE-MRI were 0.67 (95% CI, 0.63-0.71) and 0.60 (95% CI, 0.55-0.64) while diagnosing csPCa and PCa. Through meta-regression, we found that study design, magnetic field strength, the definition of csPCa, and the scoring system were the sources of heterogeneity. CONCLUSION: The results of our study indicate that the role of DCE-MRI in equivocal lesions may be limited.
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