Jie Chen, Rongbo Liu, Ping Tan
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan province, China.
Eur Radiol. 2014 Aug;24(8):1929-41. doi: 10.1007/s00330-014-3201-2. Epub 2014 May 28.
To evaluate the diagnostic performance of diffusion-weighted imaging (DWI) as a single non-invasive method in detecting prostate cancer (PCa) and to deduce its clinical utility.
A systematic literature search was performed to identify relevant original studies. Quality of included studies was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Data were extracted to calculate sensitivity and specificity as well as running the test of heterogeneity and threshold effect. The summary receiver operating characteristic (SROC) curve was drawn and area under SROC curve (AUC) served as a determination of the diagnostic performance of DWI for the detection of PCa.
A total of 21 studies were included, with 27 subsets of data available for analysis. The pooled sensitivity and specificity with corresponding 95% confidence interval (CI) were 0.62 (95% CI 0.61-0.64) and 0.90 (95% CI 0.89-0.90), respectively. Pooled positive likelihood ratio and negative likelihood ratio were 5.83 (95% CI 4.61-7.37) and 0.30 (95% CI 0.23-0.39), respectively. The AUC was 0.8991. Significant heterogeneity was observed. There was no notable publication bias.
DWI is an informative MRI modality in detecting PCa and shows moderately high diagnostic accuracy. General clinical application was limited because of the absence of standardized DW-MRI techniques.
• DWI provides incremental information for the detection and evaluation of PCa • DWI has moderately high diagnostic accuracy in detecting PCa • Patient condition, imaging protocols and study design positively influence diagnostic performance • General clinical application requires optimization of image acquisition and interpretation.
评估扩散加权成像（DWI）作为一种单一的非侵入性方法在检测前列腺癌（PCa）中的诊断性能，并推断其临床应用价值。
进行系统的文献检索以识别相关的原始研究。采用QUADAS-2（诊断准确性研究质量评估）对纳入研究的质量进行评估。提取数据以计算敏感性和特异性，并进行异质性检验和阈值效应检验。绘制汇总的受试者工作特征（SROC）曲线，以SROC曲线下面积（AUC）作为DWI检测PCa诊断性能的判定指标。
共纳入21项研究，有27个数据子集可供分析。合并的敏感性和特异性及其相应的95%置信区间（CI）分别为0.62（95%CI 0.61-0.64）和0.90（95%CI 0.89-0.90）。合并的阳性似然比和阴性似然比分别为5.83（95%CI 4.61-7.37）和0.30（95%CI 0.23-0.39）。AUC为0.8991。观察到显著的异质性。无明显的发表偏倚。
DWI是检测PCa的一种有价值的MRI模态，具有中等偏高的诊断准确性。由于缺乏标准化的DW-MRI技术，其在一般临床中的应用受到限制。
• DWI为PCa的检测和评估提供了额外信息 • DWI在检测PCa方面具有中等偏高的诊断准确性 • 患者状况、成像方案和研究设计对诊断性能有积极影响 • 一般临床应用需要优化图像采集和解读。
