Head-to-head comparison of diagnostic test accuracy between biparametric and multiparametric MRI: an updated systematic review and bivariate meta-analysis.
Carlos A Garcia-Becerra, Maria I Arias-Gallardo, Jesus E Juarez-Garcia, Veronica Soltero-Molinar, Mariabelen I Rivera-Rocha, Luis F Parra-Camaño, Natalia Garcia-Becerra, Carlos M García-Gutiérrez
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引用次数: 0
Abstract
Background: Prostate Cancer (PCa) is a leading cause of cancer-related mortality globally. Clinically significant PCa (CsPCa) is associated with more aggressive disease, making accurate diagnosis crucial. Multiparametric Magnetic Resonance Imaging (Mp-MRI) is a well-established tool for PCa detection, but the dynamic contrast-enhanced (DCE) sequence raises concerns due to cost, risks, and patient experience. Biparametric MRI (Bp-MRI) has emerged as an alternative, but its diagnostic performance compared to Mp-MRI has not been thoroughly examined through a systematic review and meta-analysis in recent years.
Methods: A systematic review and meta-analysis were conducted to compare the diagnostic accuracy of Bp-MRI and Mp-MRI for detecting CsPCa by assessing the databases MEDLINE/PubMed, CENTRAL Cochrane, and ClinicalTrials.gov. Studies published between 2012 and 2024 that compared Bp-MRI and Mp-MRI using histopathological analysis as the reference standard were included. Data were extracted to obtain diagnostic test accuracy measurements (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) and study characteristics. Statistical analysis involved two bivariate random-effects models, a summary Receiver Operating Characteristic (sROC) curve, and meta-regression models assessing the comparison of both diagnostic test accuracies and the interaction of different study-level covariates.
Results: Nineteen studies involving 5,173 patients were included. Mp-MRI demonstrated a pooled sensitivity of 0.90 (95% CI: 0.87-0.93) and a specificity of 0.64 (95% CI: 0.50-0.76), while Bp-MRI showed a pooled sensitivity of 0.89 (95% CI: 0.85-0.92) and a specificity of 0.73 (95% CI: 0.62-0.82). Both modalities showed similar diagnostic performance with overlapping sROC curves. Meta-regression revealed no statistically significant difference between the two tools, and the study-level covariates did not influence the results.
Conclusion: Bp-MRI is a viable alternative to Mp-MRI for detecting CsPCa, with comparable diagnostic accuracy, especially when contrast agents are a concern. Further prospective randomized studies are needed to confirm these findings.
期刊介绍：
Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management.
Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis.
Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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