Dynamic contrast-enhanced MRI for the detection of prostate cancer: meta-analysis.
Dynamic contrast-enhanced MRI for the detection of prostate cancer: meta-analysis.
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DOI：
10.2214/ajr.14.13373
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Kundra V
中科院分区：
文献类型：
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作者：
Tan CH;Hobbs BP;Wei W;Kundra V
本研究的目的是系统回顾和荟萃分析动态对比增强MRI （DCE-MRI）检测前列腺癌与t2加权成像标准评价的比较。在PubMed电子数据库中检索“动态对比增强”、“前列腺”和“MRI”，检索截止日期为2013年9月17日的文章。所有纳入的研究均具有组织病理学相关性。为每个研究构建了2对2的偶然性数据。使用二正态贝叶斯ROC模型来估计和比较符合条件的模式的敏感性、特异性和AUC。DCE-MRI（0.82-0.86）和弥散加权MRI（0.84-0.88）的AUC均明显优于t2加权成像（0.68-0.77）。DCE-MRI、DWI和t2加权联合成像的部分AUC较单独DCE-MRI（0.079; 0.072-0.085）和单独t2加权成像（0.079;0.074-0.084）有明显改善（0.111;0.103-0.119），而单独DWI无改善（0.099;0.091-0.108）。四种方式的敏感性和特异性相似。与单独的t2加权成像相比，DCE-MRI总体上提高了肿瘤检测的AUC。DCE-MRI分析方法需要标准化，但视觉分析与半定量方法相似。使用DCE-MRI和t2加权成像或DWI和t2加权成像的双参数方法可能是足够的，后者可能更有利于大多数常规前列腺癌成像。
The purpose of this study was to systematically review and meta-analyze dynamic contrast-enhanced MRI (DCE-MRI) for the detection of prostate cancer in comparison with standard evaluation with T2-weighted imaging. A PubMed electronic database search for the terms “dynamic contrast-enhanced,” “prostate,” and “MRI” was completed for articles up to September 17, 2013. All included studies had histopathologic correlation. Two by two contingency data were constructed for each study. A binormal bayesian ROC model was used to estimate and compare sensitivity, specificity, and AUC among eligible modalities. Both DCE-MRI (0.82–0.86) and diffusion-weighted MRI (DWI) (0.84–0.88) yielded significantly better AUC than T2-weighted imaging (0.68–0.77). Moreover, partial AUC for the combination of DCE-MRI, DWI, and T2-weighted imaging was improved significantly (0.111; 0.103–0.119) when compared with DCE-MRI alone (0.079; 0.072–0.085) and T2-weighted imaging alone (0.079; 0.074–0.084) but not DWI alone (0.099; 0.091–0.108). Sensitivity and specificity were similar among the four modalities. DCE-MRI improves AUC of tumor detection overall compared with T2-weighted imaging alone. Methods for DCE-MRI analysis require standardization, but visual analysis performs similar to semiquantitative methods. A two-parameter approach using DCE-MRI and T2-weighted imaging or DWI and T2-weighted imaging may be sufficient, and the latter may be more favorable for most routine prostate cancer imaging.