1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
2 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
AJR Am J Roentgenol. 2017 Oct;209(4):806-814. doi: 10.2214/AJR.17.18056. Epub 2017 Aug 10.
The objective of this study is to review the diagnostic performance of shear-wave elastography (SWE) in the detection of prostate cancer (PCa).
The MEDLINE, EMBASE, and Cochrane library databases were searched up to December 23, 2016. We included diagnostic accuracy studies that used SWE for PCa detection with prostatectomy or biopsy used as the reference standard. The methodologic quality of the studies was evaluated by two independent reviewers using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary ROC plot with further exploration done using meta-regression analysis and subgroup analysis.
Eight studies (a total of 1028 patients) were evaluated. The pooled sensitivity was 0.83 (95% CI, 0.66-0.92) with a specificity of 0.85 (95% CI, 0.78-0.90) for the detection of PCa. Study design (prospective vs retrospective) was the only significant factor affecting heterogeneity (p < 0.01). At subgroup analysis, the pooled sensitivity and specificity were 0.84 (95% CI, 0.64-0.94) and 0.84 (95% CI, 0.76-0.90), respectively, in studies using shear-wave speed imaging and 0.84 (95% CI, 0.64-0.94) and 0.86 (95% CI, 0.78-0.91), respectively, in studies based on per-lesion analysis.
SWE shows good performance for the detection of PCa. However, specific recommendations regarding cutoff value cannot be made because of study heterogeneity.
本研究旨在回顾剪切波弹性成像（SWE）在前列腺癌（PCa）诊断中的诊断性能。
检索 MEDLINE、EMBASE 和 Cochrane 图书馆数据库，截至 2016 年 12 月 23 日。我们纳入了使用 SWE 检测 PCa 的诊断准确性研究，以前列腺切除术或活检作为参考标准。两位独立评审员使用修订后的诊断准确性研究质量评估工具（QUADAS-2）评估研究的方法学质量。计算所有研究的敏感性和特异性。结果以分层汇总 ROC 图进行汇总，并通过荟萃回归分析和亚组分析进行进一步探讨。
评估了 8 项研究（共 1028 例患者）。检测 PCa 的汇总敏感性为 0.83（95%CI，0.66-0.92），特异性为 0.85（95%CI，0.78-0.90）。研究设计（前瞻性与回顾性）是影响异质性的唯一显著因素（p<0.01）。在亚组分析中，使用剪切波速度成像的研究的汇总敏感性和特异性分别为 0.84（95%CI，0.64-0.94）和 0.84（95%CI，0.76-0.90），基于每病灶分析的研究的汇总敏感性和特异性分别为 0.84（95%CI，0.64-0.94）和 0.86（95%CI，0.78-0.91）。
SWE 对 PCa 的检测具有良好的性能。然而，由于研究异质性，无法针对截止值提出具体建议。
