Liang Zhen, Hu Rui, Yang Yongjiao, An Neng, Duo Xiaoxin, Liu Zheng, Shi Shangheng, Liu Xiaoqiang
Department of Urology, Tianjin Medical University General Hospital, Tianjin 300000, China.
Department of Urology, Tianjin Medical University Second Hospital, Tianjin 300000, China.
Transl Androl Urol. 2020 Apr;9(2):553-573. doi: 10.21037/tau.2020.02.03.
The purpose of this study is to systematically review the literatures assessing the value of dynamic contrast enhancement (DCE) in the multiparametric magnetic resonance imaging (mpMRI) for the diagnosis of prostate cancer (PCa).
We searched Embase, PubMed and Web of science until January 2019 to extract articles exploring the possibilities whether the pre-biopsy biparametric magnetic resonance imaging (bpMRI) can replace the position of mpMRI in the diagnosis of PCa. The sensitivity and specificity of bpMRI were all included. The study quality was assessed by QUADAS-2. Bivariate random effects meta-analyses and a hierarchical summary receiver operating characteristic plot were performed for further study through Revman 5 and Stata12.
After searching, we acquired 752 articles among which 45 studies with 5,217 participants were eligible for inclusion. The positive likelihood ratio for the detection of PCa was 2.40 (95% CI: 1.50-3.80) and the negative likelihood ratio was 0.31 (95% CI: 0.18-0.53). The sensitivity and specificity were 0.77 (95% CI: 0.73-0.81) and 0.81 (95% CI: 0.76-0.85) respectively. Based on our result, pooled specificity demonstrated little difference between bpMRI and mpMRI [bpMRI, 0.81 (95% CI, 0.76-0.85); mpMRI, 0.82 (95% CI, 0.72-0.88); P=0.169]. The sensitivity, however, indicated a significant difference between these two groups [bpMRI, 0.77 (95% CI, 0.73-0.81); mpMRI, 0.84 (95% CI, 0.78-0.89); P=0.001].
bpMRI with high b-value is a sensitive tool for diagnosing PCa. Consistent results were found in multiple subgroup analysis.
本研究旨在系统回顾评估动态对比增强（DCE）在多参数磁共振成像（mpMRI）中对前列腺癌（PCa）诊断价值的文献。
我们检索了截至2019年1月的Embase、PubMed和Web of science数据库，以提取探讨活检前双参数磁共振成像（bpMRI）能否取代mpMRI在PCa诊断中地位的文章。纳入了bpMRI的敏感性和特异性。采用QUADAS - 2评估研究质量。通过Revman 5和Stata12进行双变量随机效应荟萃分析和分层汇总接受者操作特征曲线进一步研究。
检索后，我们获得752篇文章，其中45项研究、5217名参与者符合纳入标准。检测PCa的阳性似然比为2.40（95%可信区间：1.50 - 3.80），阴性似然比为0.31（95%可信区间：0.18 - 0.53）。敏感性和特异性分别为0.77（95%可信区间：0.73 - 0.81）和0.81（95%可信区间：0.76 - 0.85）。基于我们的结果，汇总特异性显示bpMRI和mpMRI之间差异不大[bpMRI，0.81（95%可信区间，0.76 - 0.85）；mpMRI，0.82（95%可信区间，0.72 - 0.88）；P = 0.169]。然而，敏感性表明两组之间存在显著差异[bpMRI，0.77（95%可信区间，0.73 - 0.81）；mpMRI，0.84（95%可信区间，0.78 - 0.89）；P = 0.001]。
高b值的bpMRI是诊断PCa的敏感工具。在多个亚组分析中发现了一致的结果。
