UCL Division of Surgery & Interventional Science, UCL Medical School, London, UK.
Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Open. 2022 Jan 5;12(1):e050376. doi: 10.1136/bmjopen-2021-050376.
Multiparametric magnetic resonance imaging (mpMRI) has improved the triage of men with suspected prostate cancer, through precision prebiopsy identification of clinically significant disease. While multiple important characteristics, including tumour grade and size have been shown to affect conspicuity on mpMRI, tumour location and association with mpMRI visibility is an underexplored facet of this field. Therefore, the objective of this systematic review and meta-analysis is to collate the extant evidence comparing MRI performance between different locations within the prostate in men with existing or suspected prostate cancer. This review will help clarify mechanisms that underpin whether a tumour is visible, and the prognostic implications of our findings.
The databases MEDLINE, PubMed, Embase and Cochrane will be systematically searched for relevant studies. Eligible studies will be full-text English-language articles that examine the effect of zonal location on mpMRI conspicuity. Two reviewers will perform study selection, data extraction and quality assessment. A third reviewer will be involved if consensus is not achieved. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will inform the methodology and reporting of the review. Study bias will be assessed using a modified Newcastle-Ottawa scale. A thematic approach will be used to synthesise key location-based factors associated with mpMRI conspicuity. A meta-analysis will be conducted to form a pooled value of the sensitivity and specificity of mpMRI at different tumour locations.
Ethical approval is not required as it is a protocol for a systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations.
CRD42021228087.
多参数磁共振成像（mpMRI）通过在前列腺活检前精准识别有临床意义的疾病，提高了疑似前列腺癌男性的分诊能力。虽然已经证明包括肿瘤分级和大小在内的多个重要特征会影响 mpMRI 的显影，但肿瘤位置及其与 mpMRI 可视性的关系是该领域尚未充分探索的一个方面。因此，本系统评价和荟萃分析的目的是整理比较不同位置前列腺内肿瘤的 MRI 表现的现有证据，这些证据来自于存在或疑似前列腺癌的男性。本综述将有助于阐明肿瘤是否可见的潜在机制，以及我们研究结果的预后意义。
将系统地在 MEDLINE、PubMed、Embase 和 Cochrane 数据库中搜索相关研究。符合条件的研究将是全文为英文且检查分区位置对 mpMRI 显影影响的研究。两位评审员将进行研究选择、数据提取和质量评估。如果无法达成共识，将邀请第三位评审员参与。综述的方法学和报告将遵循系统评价和荟萃分析的首选报告项目指南。使用改良的 Newcastle-Ottawa 量表评估研究偏倚。将采用主题方法综合与 mpMRI 显影相关的关键位置因素。将进行荟萃分析，形成不同肿瘤位置 mpMRI 敏感性和特异性的汇总值。
由于这是系统评价的方案，因此不需要伦理批准。研究结果将通过同行评审的出版物和会议报告进行传播。
PROSPERO 注册号：CRD42021228087。
