Comparison of multiparametric magnetic resonance imaging with prostate-specific membrane antigen positron-emission tomography imaging in primary prostate cancer diagnosis: A systematic review and meta-analysis

Zhao, Yi, Simpson, Benjamin S., Morka, Naomi, Freeman, Alex, Kirkham, Alex, Kelly, Daniel ORCID: https://orcid.org/0000-0002-1847-0655, Whitaker, Hayley C., Emberton, Mark and Norris, Joseph M. 2022. Comparison of multiparametric magnetic resonance imaging with prostate-specific membrane antigen positron-emission tomography imaging in primary prostate cancer diagnosis: A systematic review and meta-analysis. Cancers 14 (14) , e3497. 10.3390/cancers14143497

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Abstract

Multiparametric magnetic-resonance imaging (mpMRI) has proven utility in diagnosing primary prostate cancer. However, the diagnostic potential of prostate-specific membrane antigen positron-emission tomography (PSMA PET) has yet to be established. This study aims to systematically review the current literature comparing the diagnostic performance of mpMRI and PSMA PET imaging to diagnose primary prostate cancer. A systematic literature search was performed up to December 2021. Quality analyses were conducted using the QUADAS-2 tool. The reference standard was whole-mount prostatectomy or prostate biopsy. Statistical analysis involved the pooling of the reported diagnostic performances of each modality, and differences in per-patient and per-lesion analysis were compared using a Fisher’s exact test. Ten articles were included in the meta-analysis. At a per-patient level, the pooled values of sensitivity, specificity, and area under the curve (AUC) for mpMRI and PSMA PET/CT were 0.87 (95% CI: 0.83−0.91) vs. 0.93 (95% CI: 0.90−0.96, p 0.01); 0.47 (95% CI: 0.23−0.71) vs. 0.54 (95% CI: 0.23−0.84, p > 0.05); and 0.84 vs. 0.91, respectively. At a per-lesion level, the pooled sensitivity, specificity, and AUC value for mpMRI and PSMA PET/CT were lower, at 0.63 (95% CI: 0.52−0.74) vs. 0.79 (95% CI: 0.62−0.92, p 0.001); 0.88 (95% CI: 0.81−0.95) vs. 0.71 (95% CI: 0.47−0.90, p 0.05); and 0.83 vs. 0.84, respectively. High heterogeneity was observed between studies. PSMA PET/CT may better confirm the presence of prostate cancer than mpMRI. However, both modalities appear comparable in determining the localisation of the lesions.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Healthcare Sciences
Additional Information:	License information from Publisher: LICENSE 1: URL: https://creativecommons.org/licenses/by/4.0/
Publisher:	MDPI
Date of First Compliant Deposit:	21 July 2022
Date of Acceptance:	12 July 2022
Last Modified:	09 May 2023 09:40
URI:	https://orca.cardiff.ac.uk/id/eprint/151402

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