Work

Abbreviated biparametric versus multiparametric MRI for the detection of clinically significant prostate cancer in treatment-naïve patients: a diagnostic test accuracy systematic review and meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: OBJECTIVE: The study aims to conduct a diagnostic test accuracy systematic review and meta-analysis to compare the abbreviated biparametric magnetic resonance imaging (MRI) [bpMRI; T2-weighted imaging (T2WI) and DWI] and multiparametric MRI [mpMRI; T2WI, DWI and dynamic contrast-enhanced (DCE) MRI] for the detection of clinically significant prostate cancer (csPCa) in treatment-naïve patients. METHODS AND MATERIALS: Two independent reviewers performed a systematic search of electronic databases (PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov) from January 2012 to July 2025 using predefined search criteria. The index test was bpMRI and/or mpMRI, and the reference standard was histopathological findings from prostate biopsy or radical prostatectomy. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the risk of bias of included articles. Assessing the methodological quality of systematic reviews, and Grading of Recommendations, Assessment, Development and Evaluation working group classification were employed to assess the study quality. The sensitivity and specificity were pooled by a bivariate random-effects model and graphically presented with summary receiver operator curve (SROC) curves. Multiple subgroup analyses of possible covariates were employed to explore potential heterogeneity. RESULTS: A total of 25 studies were included in our review. For bpMRI, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) was 0.87 (95% CI, 0.83-0.92), 0.67 (95% CI, 0.59-0.76), 2.7 (95% CI, 2.1-3.4), 0.19 (95% CI, 0.14-0.24), and 14 (95% CI, 10-21), respectively. For mpMRI, the pooled sensitivity, specificity, PLR, NLR, and DOR was 0.89 (95% CI, 0.86-0.93), 0.66 (95% CI, 0.57-0.75), 2.6 (95% CI, 2.1-3.3), 0.16 (95% CI, 0.11-0.22), 17 (95% CI, 11-25). The area under the curve value of SROC curve was 0.88 (95% CI, 0.83-0.89), 0.87 (95% CI, 0.84-0.89) for bpMRI and mpMRI. Meta-regression showed that mpMRI achieved significantly higher sensitivity than bpMRI, while the two modalities demonstrated comparable specificity. CONCLUSIONS: This systematic review and meta-analysis suggested that mpMRI offered significantly higher sensitivity while maintaining equivalent specificity for csPCa detection compared to bpMRI. Whether adopting bpMRI as a substitute for mpMRI remains an issue and warrants careful consideration. More prospective multicenter, comparative studies are warranted to validate our results.

Source: International Journal of Surgery

DOI: 10.1097/js9.0000000000003893