Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis
Abstract Objectives To systematically determine the diagnostic performance of each MRI feature of the PI-RADS for predicting extraprostatic extension (EPE) in prostate cancer. Methods A literature search in the MEDLINE and EMBASE databases was conducted to identify original studies reporting the acc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-05-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-023-01422-9 |
| _version_ | 1797827525575966720 |
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| author | Moon Hyung Choi Dong Hwan Kim Young Joon Lee Sung Eun Rha Ji Youl Lee |
| author_facet | Moon Hyung Choi Dong Hwan Kim Young Joon Lee Sung Eun Rha Ji Youl Lee |
| author_sort | Moon Hyung Choi |
| collection | DOAJ |
| description | Abstract Objectives To systematically determine the diagnostic performance of each MRI feature of the PI-RADS for predicting extraprostatic extension (EPE) in prostate cancer. Methods A literature search in the MEDLINE and EMBASE databases was conducted to identify original studies reporting the accuracy of each feature on MRI for the dichotomous diagnosis of EPE. The meta-analytic pooled diagnostic odds ratio (DOR), sensitivity, specificity, and their 95% confidence intervals (CIs) were obtained using a bivariate random-effects model. Results After screening 1955 studies, 17 studies with a total of 3062 men were included. All six imaging features, i.e., bulging prostatic contour, irregular or spiculated margin, asymmetry or invasion of neurovascular bundle, obliteration of rectoprostatic angle, tumor-capsule interface > 10 mm, and breach of the capsule with evidence of direct tumor extension, were significantly associated with EPE. Breach of the capsule with direct tumor extension demonstrated the highest pooled DOR (15.6, 95% CI [7.7–31.5]) followed by tumor-capsule interface > 10 mm (10.5 [5.4–20.2]), asymmetry or invasion of neurovascular bundle (7.6 [3.8–15.2]), and obliteration of rectoprostatic angle (6.1 [3.8–9.8]). Irregular or spiculated margin showed the lowest pooled DOR (2.3 [1.3–4.2]). Breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm showed the highest pooled specificity (98.0% [96.2–99.0]) and sensitivity (86.3% [70.0–94.4]), respectively. Conclusions Among the six MRI features of prostate cancer, breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm were the most predictive of EPE with the highest specificity and sensitivity, respectively. Graphical abstract |
| first_indexed | 2024-04-09T12:49:43Z |
| format | Article |
| id | doaj.art-a9a54fa8ad7d434b8c52a930f00ed8e0 |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-04-09T12:49:43Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-a9a54fa8ad7d434b8c52a930f00ed8e02023-05-14T11:19:07ZengSpringerOpenInsights into Imaging1869-41012023-05-0114111210.1186/s13244-023-01422-9Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysisMoon Hyung Choi0Dong Hwan Kim1Young Joon Lee2Sung Eun Rha3Ji Youl Lee4Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract Objectives To systematically determine the diagnostic performance of each MRI feature of the PI-RADS for predicting extraprostatic extension (EPE) in prostate cancer. Methods A literature search in the MEDLINE and EMBASE databases was conducted to identify original studies reporting the accuracy of each feature on MRI for the dichotomous diagnosis of EPE. The meta-analytic pooled diagnostic odds ratio (DOR), sensitivity, specificity, and their 95% confidence intervals (CIs) were obtained using a bivariate random-effects model. Results After screening 1955 studies, 17 studies with a total of 3062 men were included. All six imaging features, i.e., bulging prostatic contour, irregular or spiculated margin, asymmetry or invasion of neurovascular bundle, obliteration of rectoprostatic angle, tumor-capsule interface > 10 mm, and breach of the capsule with evidence of direct tumor extension, were significantly associated with EPE. Breach of the capsule with direct tumor extension demonstrated the highest pooled DOR (15.6, 95% CI [7.7–31.5]) followed by tumor-capsule interface > 10 mm (10.5 [5.4–20.2]), asymmetry or invasion of neurovascular bundle (7.6 [3.8–15.2]), and obliteration of rectoprostatic angle (6.1 [3.8–9.8]). Irregular or spiculated margin showed the lowest pooled DOR (2.3 [1.3–4.2]). Breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm showed the highest pooled specificity (98.0% [96.2–99.0]) and sensitivity (86.3% [70.0–94.4]), respectively. Conclusions Among the six MRI features of prostate cancer, breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm were the most predictive of EPE with the highest specificity and sensitivity, respectively. Graphical abstracthttps://doi.org/10.1186/s13244-023-01422-9Prostatic neoplasmsNeoplasm stagingMagnetic resonance imagingSystematic reviewMeta-analysis |
| spellingShingle | Moon Hyung Choi Dong Hwan Kim Young Joon Lee Sung Eun Rha Ji Youl Lee Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis Insights into Imaging Prostatic neoplasms Neoplasm staging Magnetic resonance imaging Systematic review Meta-analysis |
| title | Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis |
| title_full | Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis |
| title_fullStr | Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis |
| title_full_unstemmed | Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis |
| title_short | Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis |
| title_sort | imaging features of the pi rads for predicting extraprostatic extension of prostate cancer systematic review and meta analysis |
| topic | Prostatic neoplasms Neoplasm staging Magnetic resonance imaging Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s13244-023-01422-9 |
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