Performance of Multiparametric MRI of the Prostate in Biopsy Naïve Men: A Meta-analysis of Prospective Studies.

Autor: Becerra MF; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Alameddine M; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Zucker I; Department of Urology, University of Miami Miller School of Medicine, Miami, FL; Herbert Wertheim College of Medicine at Florida International University, Miami, FL., Tamariz L; Department of Medicine, University of Miami Miller School of Medicine, Miami, FL., Palacio A; Department of Medicine, University of Miami Miller School of Medicine, Miami, FL., Nemeth Z; Department of Health Informatics, University of Miami Miller School of Medicine, Miami, FL., Velasquez MC; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Savio LF; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Panizzutti M; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Jue JS; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Soodana-Prakash N; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Ritch CR; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Gonzalgo ML; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Parekh DJ; Department of Urology, University of Miami Miller School of Medicine, Miami, FL., Punnen S; Department of Urology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: s.punnen@miami.edu.
Jazyk: angličtina
Zdroj: Urology [Urology] 2020 Dec; Vol. 146, pp. 189-195. Date of Electronic Publication: 2020 Sep 02.
DOI: 10.1016/j.urology.2020.06.102
Abstrakt: Objective: To assess the outcomes through systematic review and meta-analysis of multi-parametric magnetic resonance imaging (mpMRI) of the prostate in biopsy naïve men.
Methods: Systemic review and meta-analysis was performed to assess the performance of mpMRI on prostate cancer (PCa) detection at the time of biopsy. We used standard methods for performing a meta-analysis evaluating a diagnostic test and reported the pooled sensitivity and specificity, and the positive and negative likelihood ratios (LR) for mpMRI in the detection of any and clinically significant prostate cancer (csPCa).
Results: A total of 10 studies comprising 2486 patients were analyzed. Overall, if biopsies would have been performed only in men with an mpMRI suspicious for malignancy between 7.4% and 58.5% of the biopsies could have been avoided, but 2.3%-36% of any PCa and 0%-30.8% of csPCa would have been missed. The sensitivity, specificity, positive LR, and negative LR of mpMRI for any PCa detection were 0.86 (95% confidence interval [CI], 0.78-0.91), 0.67 (95% CI, 0.40-0.86), 2.6 (95% CI, 1.2-5.5), and 0.2 (95% CI, 0.12-0.32), respectively. The AUC for any PCa detection was 0.84 (95% CI, 0.75-0.90). The pooled sensitivity, specificity, positive LR, and negative LR of mpMRI for csPCa detection was 0.94 (95% CI, 0.83-0.98), 0.54 (95% CI, 0.42-0.65), 2 (95% CI, 1.5-2.7), and 0.1 (95% CI, 0.02-0.35), respectively. The AUC for csPCa detection was 0.94 (95% CI, 0.65-1).
Conclusion: This study provides summary estimates indicating that mpMRI can accurately detect prostate cancer and help avoid unnecessary biopsies in this population.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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