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Material and Methods: A comprehensive literature search of published and unpublished databases was performed.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.
Original language | English |
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Pages (from-to) | 105-113 |
Number of pages | 9 |
Journal | Acta Radiologica |
Volume | 59 |
Issue number | 1 |
Early online date | 4 Apr 2017 |
DOIs | |
Publication status | Published - 1 Jan 2018 |
Keywords
- Prostate cancer
- MRI
- diffusion-weighted imaging
- DWI
- high-b-value
- meta-analysis