Accuracy of high b-value diffusion-weighted MRI for prostate cancer detection: a meta-analysis

Godley, Keith; Syer, Tom; Toms, Andoni P.; Smith, Toby; Johnson, Glyn; Cameron, Donnie; Malcolm, Paul

doi:10.1177/0284185117702181

Cited by 16 publications

(7 citation statements)

References 45 publications

(133 reference statements)

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“…Our pooled results match those of meta-analyses investigating T 2 WI and DWI by Wu et al and Tan et al; this is likely due to the large overlap of included studies [ 28 , 29 ]. Compared with Godley et al and Jie et al who analyzed the use of DWI alone, we observed a higher sensitivity but lower specificity [ 5 , 30 ]. However, when we compare the results for just peripheral zone tumors, our pooled results are similar.…”

Section: Discussioncontrasting

confidence: 79%

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The diagnostic accuracy of high b-value diffusion- and T2-weighted imaging for the detection of prostate cancer: a meta-analysis

et al. 2017

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PurposeThis study aims to investigate the role of diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) in combination for the detection of prostate cancer, specifically assessing the role of high b-values (> 1000 s/mm2), with a systematic review and meta-analysis of the existing published data.MethodsThe electronic databases MEDLINE, EMBASE, and OpenSIGLE were searched between inception and September 1, 2017. Eligible studies were those that reported the sensitivity and specificity of DWI and T2WI for the diagnosis of prostate cancer by visual assessment using a histopathologic reference standard. The QUADAS-2 critical appraisal tool was used to assess the quality of included studies. A meta-analysis with pooling of sensitivity, specificity, likelihood, and diagnostic odds ratios was undertaken, and a summary receiver-operating characteristics (sROC) curve was constructed. Predetermined subgroup analysis was also performed.ResultsThirty-three studies were included in the final analysis, evaluating 2949 patients. The pooled sensitivity and specificity were 0.69 (95% CI 0.68–0.69) and 0.84 (95% CI 0.83–0.85), respectively, and the sROC AUC was 0.84 (95% CI 0.81–0.87). Subgroup analysis showed significantly better sensitivity with high b-values (> 1000 s/mm2). There was high statistical heterogeneity between studies.ConclusionThe diagnostic accuracy of combined DWI and T2WI is good with high b-values (> 1000 s/mm2) seeming to improve overall sensitivity while maintaining specificity. However, further large-scale studies specifically looking at b-value choice are required before a categorical recommendation can be made.Electronic supplementary materialThe online version of this article (10.1007/s00261-017-1400-4) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 79%

“…Compared with Godley et al and Jie et al who analyzed the use of DWI alone, we observed a higher sensitivity but lower specificity [5, 30]. However, when we compare the results for just peripheral zone tumors, our pooled results are similar.…”

Section: Discussionsupporting

confidence: 55%

The diagnostic accuracy of high b-value diffusion- and T2-weighted imaging for the detection of prostate cancer: a meta-analysis

et al. 2017

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“…43,44 Despite some conflicting reports, the general consensus is that higher b-values can provide better conspicuity for tumor detection, provided that an adequate SNR (eg, 5-10) can be maintained. 45,46 This has led to recent adoption of high b-value (1400-2000 s/mm 2 ) DWI in Prostate Imaging Reporting and Data System (PI-RADS) Version 2. 47 Achieving an adequate SNR at high b-values can be challenging.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…The potential value of high b-values for cancer detection has also been investigated in several other cancers 43,44 . Despite some conflicting reports, the general consensus is that higher b-values can provide better conspicuity for tumor detection, provided that an adequate SNR (e.g., 5–10) can be maintained 45,46 . This has led to recent adoption of high b-value (1400–2000 s/mm 2 ) DWI in Prostate Imaging Reporting and Data System (PI-RADS) Version 2 47 .…”

Section: Clinical Applicationsmentioning

confidence: 99%

Diffusion MRI of cancer: From low to high b‐values

Tang

Zhou

2018

Magnetic Resonance Imaging

154

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Following its success in early detection of cerebral ischemia, diffusion-weighted imaging (DWI) has been increasingly used in cancer diagnosis and treatment evaluation. These applications are propelled by the rapid development of novel diffusion models to extract biologically valuable information from diffusion-weighted MR signals, and significant advance in MR hardware that has enabled image acquisition with high b-values. This article reviews recent technical developments and clinical applications in cancer imaging using DWI, with a special emphasis on high b-value diffusion models. The article is organized in four sections. First, we provide an overview of diffusion models that are relevant to cancer imaging. The model parameters are discussed in relation to three tissue properties – cellularly, vascularity, and microstructures. An emphasis is placed on characterization of microstructural heterogeneity, given its novelty and close relevance to cancer. Second, we illustrate diffusion MR clinical applications in each of the following three categories: (a) cancer detection and diagnosis; (b) cancer grading, staging, and classification; and (c) cancer treatment response prediction and evaluation. Third, we discuss several practical issues, including selection of image acquisition parameters, reproducibility and reliability, motion management, image distortion, etc., that are commonly encountered when applying DWI to cancer in clinical settings. Lastly, we highlight a few ongoing challenges and provide some possible future directions, particularly in the area of establishing standards via well-organized multi-center clinical trials to accelerate clinical translation of advanced DWI techniques to improving cancer care on a large scale.

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“…Ahmed et al[1] found that the sensitivity of mpMRI for the detection of clinically significant disease was 93% (95%CI: 88%-96%), which was significantly superior to the sensitivity of TRUS biopsy (48%; 95%CI: 42%-55%). One meta-analysis showed that the pooled sensitivity and speciﬁcity of mpMRI for prostate cancer detection are 74% and 88%, respectively[16]. Assessment of lymph node involvement can be performed by both CT and mpMRI, but both have a very low sensitivity[17].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques

Xing

Wang

et al. 2019

WJCC

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BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ultrasound-guided prostate biopsy to detect prostate cancer is limited. Nowadays, a variety of diagnostic methods and more sensitive diagnostic methods, such as multi-parameter prostate magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) can be applied clinically. Furthermore, laparoscopic/robot-assisted prostatectomy is also a safe and effective procedure for the treatment of benign prostatic hyperplasia. So maybe it is time to reconsider the necessary to perform prostate biopsy before radical prostatectomy. AIM To explore the feasibility of radical prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques. METHODS From June 2014 to November 2018, 11 cases of laparoscopic radical prostatectomy without prostate biopsy were performed at the three tertiary medical centers involved in this study. All patients received prostate magnetic resonance imaging and prostate cancer was suspected, including six patients with positive 68 Ga-PSMA PET/CT results. Laparoscopic radical prostatectomy and pelvic lymph node dissection were performed for all patients. RESULTS All surgeries were accomplished successfully. The mean age was 69 ± 7.7 year, the mean body mass index was 24.7 ± 1.6 kg/m 2 , the range of serum PSA was 4.3 to >1000 ng/mL, and the mean prostate volume was 40.9 ± 18.3 mL. The mean operative time was 96 ± 23.3 min, the mean estimated blood loss was 90 ± 90.9 mL, and the median duration of catheter placement was 14 d. The final pathology confirmed that all specimens were prostate cancer except one case of benign prostatic hyperplasia. No major complications occurred in 90 d postoperatively. CONCLUSION The current practice of mandating a prostatic biopsy before prostatectomy should be reconsidered in the era of new imaging technology and minimally invasive techniques. Radical prostatectomy could be carried out without the evidence of malignancy. Large-sample randomized controlled trials are definitely required to confirm the feasibility of this new concept.

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Accuracy of high b-value diffusion-weighted MRI for prostate cancer detection: a meta-analysis

Abstract: Background: The diagnostic accuracy of diffusion-weighted imaging (DWI) to detect

Cited by 16 publications

References 45 publications

The diagnostic accuracy of high b-value diffusion- and T2-weighted imaging for the detection of prostate cancer: a meta-analysis

The diagnostic accuracy of high b-value diffusion- and T2-weighted imaging for the detection of prostate cancer: a meta-analysis

Diffusion MRI of cancer: From low to high b‐values

Feasibility of prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques

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