MRI和TRUS在前列腺癌检测中的差异:94,020例的系统回顾和荟萃分析。

Ashkan Bahrami, Long H Tu, Milad Ghanikolahloo, Zohreh Sadeghi, Armin Tafazolimoghadam, Mahan Farzan, Mobina Fathi, Yaser Khakpour, Arian Tavasol, Milad Alipour, Ahmad Shoja, Mobin Azami, Thomas Clifford, Ramtin Hajibeygi, Samra Iftikhar
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引用次数: 0

摘要

背景:前列腺癌(PC)是最常见的癌症之一,是男性癌症死亡的第二大原因。最近的证据表明,在影像学应用和PC诊断方面存在种族差异。目的:本系统综述和荟萃分析的目的是量化不同种族(白人、黑人、亚洲人、高加索人、西班牙裔和其他种族)在使用磁共振成像(MRI)和经直肠超声(TRUS)诊断PC方面的差异。然而,我们的研究重点是在北美人群中观察到的差异,因为大多数研究都是在加拿大和美国进行的。材料和方法:我们在谷歌Scholar、PubMed/Medline、Web of Science、Scopus和EMBASE数据库中进行了系统的检索。共收录了在2024年8月之前发表的33篇相关文章。我们使用Stata版本15进行统计分析。采用I2统计来评估异质性。Egger和Begg的测试评估了任何发表偏倚。结果:33篇文章共包含94,020例病例,平均年龄为77.9岁,涉及六个定义的种族(非裔美国人或黑人、白人、亚洲人、高加索人、西班牙裔和其他种族)。分析表明,白人患者MRI使用率较高,黑人患者66% (95% CI: 0.59-0.73; I2 = 99.5%),黑人患者19% (95% CI: 0.17-0.22; I2 = 98.95%),白种人患者67% (95% CI: 0.56-0.78; I2 = 98.99%),西班牙裔患者7% (95% CI: 0.04-0.09; I2 = 97.55%),亚洲患者4% (95% CI: 0.03-0.05; I2 = 86.53%),其他种族患者24% (95% CI: 0.11-0.37; I2 = 99.94%)。此外,黑人患者的TRUS使用率相对较低,为30% (95% CI: 0.15-0.44, I2= 99.75%)。结论:本系统回顾和荟萃分析显示,白人患者的MRI诊断PC的使用率分别高于黑人、西班牙裔和亚洲人。此外,黑人群体中TRUS的使用相对有限。这些结果表明需要改变放射学利用和卫生政策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disparities in MRI and TRUS for prostate cancer detection: A systematic review and meta-analysis of 94,020 cases.

Background: Prostate cancer (PC) is one of the most prevalent cancers and is the second leading cause of cancer death in men. Recent evidence has demonstrated racial disparities in imaging utilization and, as a result, PC diagnosis.

Purpose: The goal of this systematic review and meta-analysis was to quantify the disparity in utilization of Magnetic Resonance Imaging (MRI) and Transrectal Ultrasound (TRUS) for PC diagnosis among different races (Whites, Blacks, Asians, Caucasians, Hispanics, and other races). Our study, however, focuses on disparities observed in the North American population, as most of the studies included were carried out in Canada and the United States.

Materials and methods: We carried out a systematic search in Google Scholar, PubMed/Medline, Web of Science, Scopus, and EMBASE databases. A total of 33 relevant articles published before August 2024 were included. We used Stata version 15 for statistical analysis. I2 statistics was employed to assess heterogeneity. Egger and Begg's tests evaluated any publication bias.

Results: A total of 33 articles collectively contained 94,020 cases with a mean age of 77.9 across six defined races (African-American or Black, White, Asians, Caucasians, Hispanics, and other races). Analysis demonstrated greater utilization of MRI in White patients 66 % (95 % CI: 0.59-0.73; I2 = 99.5 %),19 % (95 % CI: 0.17-0.22; I2 = 98.95 %) in Blacks, 67 % (95 % CI: 0.56-0.78; I2 = 98.99 %) in Caucasians, 7 % (95 % CI: 0.04-0.09; I2 = 97.55 %) in Hispanics, 4 % (95 % CI: 0.03-0.05; I2 = 86.53 %) in Asians, and 24 % (95 % CI: 0.11-0.37; I2 = 99.94 %) in other races. Also, relatively low utilization of TRUS was demonstrated in Black patients at 30 % (95 % CI: 0.15-0.44, I2=99.75 %) CONCLUSION: This systematic review and meta-analysis demonstrate a higher utilization of MRI for PC diagnosis in White patients relative to Blacks, Hispanics, and Asians, respectively. In addition, the use of TRUS in the Black population is relatively limited. These outcomes indicate a need for a change in radiologic utilization and health policies.

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