Department of Radiology, McMaster University, Hamilton, ON, Canada.
Faculty of Medicine, McMaster University, Hamilton, ON, Canada.
Br J Radiol. 2021 Feb 1;94(1118):20191050. doi: 10.1259/bjr.20191050. Epub 2020 Oct 22.
To evaluate Prostate Imaging Reporting and Data System (PI-RADS) category 3 lesions' impact on the diagnostic test accuracy (DTA) of MRI for prostate cancer (PC) and to derive the prevalence of PC within each PI-RADS category.
MEDLINE and Embase were searched until April 10, 2020 for studies reporting on the DTA of MRI by PI-RADS category. Accuracy metrics were calculated using a bivariate random-effects meta-analysis with PI-RADS three lesions treated as a positive test, negative test, and excluded from the analysis. Differences in DTA were assessed utilizing meta-regression. PC prevalence within each PI-RADS category was estimated with a proportional meta-analysis.
In total, 26 studies reporting on 12,913 patients (4,853 with PC) were included. Sensitivities for PC in the positive, negative, and excluded test groups were 96% (95% confidence interval [CI] 92-98), 82% (CI 75-87), and 95% (CI 91-97), respectively. Specificities for the positive, negative, and excluded test groups were 33% (CI 23-44), 71% (CI 62-79), and 52% (CI 37-66), respectively. Meta-regression demonstrated higher sensitivity ( < 0.001) and lower specificity ( < 0.001) in the positive test group compared to the negative group. Clinically significant PC prevalences were 5.9% (CI 0-17.1), 11.4% (CI 6.5-17.3), 24.9% (CI 18.4-32.0), 55.7% (CI 47.8-63.5), and 81.4% (CI 75.9-86.4) for PI-RADS categories 1, 2, 3, 4 and 5, respectively.
PI-RADS category 3 lesions can significantly impact the DTA of MRI for PC detection. A low prevalence of clinically significant PC is noted in PI-RADS category 1 and 2 cases.
Inclusion or exclusion of PI-RADS category 3 lesions impacts the DTA of MRI for PC detection.
评估前列腺影像报告和数据系统（PI-RADS）类别 3 病变对前列腺癌（PCa）MRI 诊断检测准确性（DTA）的影响，并得出每个 PI-RADS 类别中 PCa 的患病率。
检索 MEDLINE 和 Embase 数据库，截至 2020 年 4 月 10 日，以获取关于 PI-RADS 类别报告的 MRI DTA 的研究。使用双变量随机效应荟萃分析计算准确性指标，PI-RADS 3 类病变被视为阳性、阴性和排除的测试，纳入分析。利用荟萃回归评估 DTA 差异。采用比例荟萃分析估计每个 PI-RADS 类别中的 PCa 患病率。
共纳入 26 项研究，涉及 12913 名患者（4853 名 PCa 患者）。阳性、阴性和排除试验组中 PCa 的灵敏度分别为 96%（95%置信区间 [CI] 92-98）、82%（CI 75-87）和 95%（CI 91-97），特异性分别为 33%（CI 23-44）、71%（CI 62-79）和 52%（CI 37-66）。荟萃回归显示，阳性试验组的灵敏度（<0.001）和特异性（<0.001）均高于阴性试验组。临床上有意义的 PCa 患病率分别为 5.9%（CI 0-17.1）、11.4%（CI 6.5-17.3）、24.9%（CI 18.4-32.0）、55.7%（CI 47.8-63.5）和 81.4%（CI 75.9-86.4），分别为 PI-RADS 类别 1、2、3、4 和 5。
PI-RADS 类别 3 病变可显著影响 MRI 检测 PCa 的 DTA。PI-RADS 类别 1 和 2 病例中临床显著 PCa 的患病率较低。
PI-RADS 类别 3 病变的纳入或排除会影响 MRI 检测 PCa 的 DTA。
