To assess the outcomes through systematic review and metanalysis of Multi-parametric MRI (mpMRI) of the prostate in biopsy naïve men.
Systemic review and meta-analysis was performed to assess the performance of mpMRI on 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).
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 – 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% 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).
This study provides summary estimates indicating that mpMRI can accurately detect prostate cancer and help avoid unnecessary biopsies in this population.
Copyright © 2020. Published by Elsevier Inc.