Magnetic Resonance Image in the diagnosis and evaluation of extra-prostatic extension and involvement of seminal vesicles of prostate cancer: a systematic review of literature and meta-analysis

Abstract

Objective: Systematic review of literature and meta-analysis to evaluate the results of magnetic resonance image 1.5T with endorectal coil in the diagnosis and evaluation of extra-prostatic extension and involvement of seminal vesicles of prostate cancer, compared to the histopathological results of the radical prostatectomy specimen. Materials and Methods: It was conducted a systematic review of literature and meta--analyses of all studies data published after 2008. In those studies, the patients with prostate cancer with indication to radical prostatectomy were submitted to magnetic resonance image (MRI) at pre-operatory period and the results were compared to those of histopathological studies after the surgery. The selected terms for research included prostate cancer, magnetic resonance, radical prostatectomy, and prostate cancer diagnosis, in the databases EMBASE, LILACS, PUBMED/MEDLINE and Cochrane Library. The data were collected using a specific qualitative instrument and the meta-analysis data were presented in the forest plot graphics, homogeneity test and sROC curves and funnel plot. Results: A total of seven studies were included, with a total of 603 patients. Among these studies, six evaluated the value of MRI for the detection of prostate cancer, and the median sensitivity of meta-analysis was 0.6 and specificity 0.58, but with heterogeneity among the studies. Three studies evaluated extra-prostatic extension with a median sensitivity of 0.49, specificity 0.82 and heterogeneity only for sensitivity. Three studies evaluated invasion of seminal vesicles, with median sensitivity of 0.45 and specificity 0.96, with heterogeneity in both analysis. Conclusion: Magnetic resonance of 1.5T with endocoil showed low values of sensitivity and specificity for the diagnosis and staging of prostate cancer. The reviewed studies showed a significant heterogeneity among them. The best observed result was MRI specificity for invasion of seminal vesicles. More studies are necessary to evaluate new techniques and parameters before recommending the routine use of MRI in clinical practice.

Accuracy of Magnetic Resonance Imaging for Local Staging of Prostate Cancer: A Diagnostic Meta-analysis

“…The major strength of our meta-analysis is that it provides a complete and unique overview of the literature since the last extensive meta-analysis by Engelbrecht et al [7] and the survey was not restricted to certain imaging parameters as in the meta-analysis by Silva et al [8]. Therefore, many studies could be included and sensitivity analyses of the most important patient, study, and imaging characteristics were possible.…”

“…Engelbrecht et al [7] included literature up to 2000, and a more recent survey by Silva et al [8] was restricted to studies using 1.5-T devices with an ERC. Since 2000, local PCa staging has been studied extensively using many different imaging protocols.…”

State‐of‐the‐art imaging techniques in the management of preoperative staging and re‐staging of prostate cancer

“…In their meta-analysis including seven studies using 1.5 T and endorectal coil, Silva et al showed a pooled sensitivity and specificity of 0.49 (95% CI 0.40-0.58) and 0.82 (95% CI 0.77-0.86) for ECE, and 0.45 (95% CI 0.31-0.60) and 0.96 (95% CI 0.93-0.98) for seminal vesicle invasion. 18 A recent metaanalysis including 75 studies without limitations on field strength or coil use reported a pooled sensitivity and specificity of 0.57 (95% CI 0.49-0.65) and 0.91 (95% CI 0.88-0.93) for ECE, 0.58 (95% CI 0.47-0.68) and 0.97 (95% CI 0.95-0.98) for seminal vesicle invasion, and 0.61 (95% CI 0.54-0.67) and 0.88 (95% CI 0.85-0.91) for overall stage T3. 19 The authors also stated that sensitivity of T2- wedged images with 1.5 or 3 T for extraprostatic disease can be improved by adding functional techniques, such as DWI and DCE.…”

“…Furthermore, it is strongly correlated with life expectancy, representing a good indicator of prognosis. 84 11 C-choline or 18 F-choline PET/CT has mostly been investigated in restaging after primary treatment. 85 However, its diagnostic accuracy is still suboptimal.…”

Multiparametric MRI for Localized Prostate Cancer: Lesion Detection and Staging

“…The performance for staging rather than detection of prostate cancer has focused more on sensitivity and specificity for EPE in the context of surgical planning. A meta-analysis in 2013 looking at 7 studies with a total of 603 subjects found a median sensitivity of 0.49 and specificity 0.82 for EPE with marked heterogeneity [ 44 ]. Although it is straightforward to determine the presence or absence of EPE, it is difficult to compare performance.…”