Predictive Value of Multiparametric Magnetic Resonance Imaging (T2-weighted Imaging and Apparent Diffusion Coefficient) for Pathological Grading of Prostate Cancer: a Meta-Analysis.

Abstract

Objective: This meta-analysis aimed to evaluate the predictive value of multiparametric magnetic resonance imaging (mpMRI), specifically T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) maps, in the pathological grading of prostate cancer.

Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, the China National Knowledge Infrastructure dataset, Web of Science, Springer Link and Cochrane Library. Studies evaluating the use of mpMRI for prostate cancer grading were included. The quality of the included studies was assessed using the risk of bias tool. Meta-analyses were performed to calculate pooled areas under the curve (AUC) and prostate cancer detection rates.

Results: Seven studies met the inclusion criteria, comprising 843 patients in the experimental group and 962 in the control group. The meta-analysis revealed a significant improvement in diagnostic performance with mpMRI, with a pooled mean difference in AUC of 0.10 (95% confidence interval [CI]: 0.04-0.16, p = 0.002) favouring the mpMRI group. The odds ratio for prostate cancer detection was 2.60 (95% CI: 1.57-4.29, p = 0.0002), indicating a higher detection rate with mpMRI compared with standard techniques. Substantial heterogeneity was observed among the studies (I² = 73% for AUC and 66% for detection rate).

Conclusion: This meta-analysis demonstrates that mpMRI, particularly T2WI and ADC imaging, has a significant predictive value in the pathological grading of prostate cancer. The technique shows improved diagnostic accuracy and higher cancer detection rates compared with conventional methods. However, the substantial heterogeneity among studies suggests that standardisation of mpMRI protocols and interpretation criteria is needed.