Role of multiparametric magnetic resonance imaging for patients under active surveillance for prostate cancer: a systematic review with diagnostic meta-analysis

Francesco Cantiello, Giorgio Ivan Russo, Sascha Kaufmann, Giovanni Cacciamani, Fabio Crocerossa, Matteo Ferro, Ottavio De Cobelli, Walter Artibani, Sebastiano Cimino, Giuseppe Morgia, Rocco Damiano, Konstantin Nikolaou, Nils Kröger, Arnulf Stenzl, Jens Bedke, Stephan Kruck

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The use of multiparametric magnetic resonance imaging (mpMRI) in the setting of patients under active surveillance (AS) is promising. In this systematic-review we aimed to analyse the role of mpMRI in patients under AS. Methods: A comprehensive literature research for English-language original and review articles, recently published, was carried out using Medline, Scopus and Web of sciences databases until 30 October 2017. The following MeSH terms were used: 'active surveillance', 'prostate cancer', 'multiparametric magnetic resonance imaging'. A diagnostic meta-analysis was performed for 3.0 T mpMRI in predicting disease re-classification. Results: In total, 226 studies were selected after research and after removal of duplicates. After analysis on inclusion criteria, 43 studies were identified as eligible for this systematic review with a total of 6,605 patients. The timing of MRI during follow-up of AS differed from all studies like criteria for inclusion in the AS protocol. Overall, there was a low risk of bias across all studies. The diagnostic meta-analysis for 1.5 tesla showed a sensitivity of 0.60, negative predictive value (NPV) of 0.75 and a hierarchical summary receiving operating curve (HSROC) of 0.74 while for 3.0 tesla mpMRI a sensitivity of 0.81, a NPV of 0.78 and a HSROC of 0.83. Conclusions: Overall, the available evidence suggests that both 1.5 or 3.0 Tesla mpMRI are a valid tool to monitor progression during AS follow-up, showing good accuracy capabilities in detecting PCa re-classification. However, the modality to better define what means 'disease progression' on mpMRI must be further evaluated.

Original languageEnglish
Pages (from-to)206-220
Number of pages15
JournalProstate Cancer and Prostatic Diseases
Volume22
Issue number2
DOIs
Publication statusPublished - May 1 2019

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research

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