Godley, Keith, Syer, Tom, Toms, Andoni, Smith, Toby ORCID: https://orcid.org/0000-0003-1673-2954, Johnson, Glyn, Cameron, Donnie ORCID: https://orcid.org/0000-0001-9841-6909 and Malcolm, Paul (2018) Accuracy of high b-value diffusion-weighted MRI for prostate cancer detection: a meta-analysis. Acta Radiologica, 59 (1). pp. 105-113. ISSN 1600-0455
Preview |
PDF (Meta-analysis 2nd revision final with figures ACCEPTED)
- Accepted Version
Available under License Unspecified licence. Download (764kB) | Preview |
Abstract
Background: The diagnostic accuracy of diffusion-weighted imaging (DWI) to detect prostate cancer is well-established. DWI provides visual and also quantitative means of detecting tumor, the Apparent Diffusion Coefficient (ADC). Recently higher b-values have been used to improve DWI’s diagnostic performance. Purpose: To determine the diagnostic performance of high b-value DWI at detecting prostate cancer and whether quantifying ADC improves accuracy. Material and Methods: A comprehensive literature search of published and unpublished databases was performed. Eligible studies had histopathologically proven prostate cancer, DWI sequences using b-values ≥ 1000 s/mm2, > 10 patients, and data for creating a 2x2 table. Study quality was assessed with QUADAS-2 (Quality Assessment of diagnostic Accuracy Studies). Sensitivity and specificity were calculated and tests for statistical heterogeneity and threshold effect performed. Results were plotted on a summary receiver operating characteristic curve (sROC) and the area under the curve (AUC) determined the diagnostic performance of high b-value DWI. Results: Ten studies met eligibility criteria with 13 subsets of data available for analysis, including 522 patients. Pooled sensitivity and specificity were 0.59 (95% CI 0.57–0.61) and 0.92 (95% CI 0.91–0.92) respectively and the sROC AUC was 0.92. Subgroup analysis showed a statistically significant (p=0.03) improvement in accuracy when using tumor visual assessment rather than ADC. Conclusion: High b-value DWI gives good diagnostic performance for prostate cancer detection and visual assessment of tumor diffusion is significantly more accurate than ROI measurements of ADC.
Downloads
Downloads per month over past year
Actions (login required)
View Item |