Hövels A M, Heesakkers R A M, Adang E M, Jager G J, Strum S, Hoogeveen Y L, Severens J L, Barentsz J O
Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, The Netherlands.
Clin Radiol. 2008 Apr;63(4):387-95. doi: 10.1016/j.crad.2007.05.022. Epub 2008 Feb 4.
To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of lymph node metastases in prostate cancer.
After a comprehensive literature search, studies were included that allowed construction of contingency tables for detection of lymph node metastases using CT or MRI. In addition, a summary receiver-operating characteristic (ROC) analysis was performed.
A total of 24 studies were included. For CT, pooled sensitivity was 0.42 (0.26-0.56 95% CI) and pooled specificity was 0.82 (0.8-0.83 95% CI). For MRI, the pooled sensitivity was 0.39 (0.22-0.56 95% CI) and pooled specificity was 0.82 (0.79-0.83 95% CI). The differences in performance of CT and MRI were not statistically significant.
CT and MRI demonstrate an equally poor performance in the detection of lymph node metastases from prostate cancer. Reliance on either CT or MRI will misrepresent the patient's true status regarding nodal metastases, and thus misdirect the therapeutic strategies offered to the patient.
比较计算机断层扫描（CT）和磁共振成像（MRI）在诊断前列腺癌淋巴结转移中的诊断准确性。
在全面检索文献后，纳入了能够构建使用CT或MRI检测淋巴结转移的列联表的研究。此外，还进行了汇总的受试者工作特征（ROC）分析。
共纳入24项研究。对于CT，汇总敏感性为0.42（0.26 - 0.56，95%置信区间），汇总特异性为0.82（0.8 - 0.83，95%置信区间）。对于MRI，汇总敏感性为0.39（0.22 - 0.56，95%置信区间），汇总特异性为0.82（0.79 - 0.83，95%置信区间）。CT和MRI性能的差异无统计学意义。
CT和MRI在检测前列腺癌淋巴结转移方面表现同样不佳。依赖CT或MRI都会误判患者淋巴结转移的真实状况，从而误导为患者提供的治疗策略。
