TY - JOUR
T1 - Prostate cancer
T2 - Diffusion-weighted imaging versus dynamic-contrast enhanced imaging for tumor localization -a meta-analysis
AU - Haghighi, Mohammad
AU - Shah, Shivam
AU - Taneja, Samir S.
AU - Rosenkrantz, Andrew B.
PY - 2013
Y1 - 2013
N2 - PURPOSE: The purpose of this study was to compare the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging for prostate cancer (PCa) detection by performing a meta-analysis of studies evaluating these techniques within the same patient cohort. METHODS: Evidence-based online databases were searched for studies reporting the performance of DWI and DCE in PCa detection in the same patient cohorts using histopathology as reference standard and providing sufficient data to construct 2 × 2 contingency tables. Pooled estimates of diagnostic performance were computed across included studies. RESULTS: Of 80 initial studies identified, 5 studies (total of 265 patients and 1730 prostatic regions) met criteria for inclusion in the meta-analysis. Pooled sensitivity was 58.4% (95% confidence interval [CI], 53.5%-63.1%) for DWI and 55.3% (95% CI, 50.4%-60.1%) for DCE. Pooled specificity was 89.0% (95% CI, 87.2%-0.7%) for DWI and 87.9% (95% CI, 86.0%-89.6%) for DCE. At summary receiver-operating-characteristic analysis, area-under-the-curve was 0.810 (0.059) for DWI and 0.786 (0.079) for DCE. Heterogeneity across studies was high for sensitivity and specificity [inconsistency index (I), >90%], although heterogeneity of specificity was substantially improved after excluding an outlier study in terms of diagnostic threshold (I = 0.0%-68.8%). Relative performance of DWI and DCE remained similar after this exclusion CONCLUSIONS: There was a paucity of studies comparing DWI and DCE in the same patient cohorts, and heterogeneity among these studies was substantial. Nevertheless, performance of DWI and DCE was similar across identified studies, with both techniques showing substantially better specificity than sensitivity. Larger studies with uniform methodology are warranted to further understand relative merits of the 2 techniques.
AB - PURPOSE: The purpose of this study was to compare the diagnostic performance of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) imaging for prostate cancer (PCa) detection by performing a meta-analysis of studies evaluating these techniques within the same patient cohort. METHODS: Evidence-based online databases were searched for studies reporting the performance of DWI and DCE in PCa detection in the same patient cohorts using histopathology as reference standard and providing sufficient data to construct 2 × 2 contingency tables. Pooled estimates of diagnostic performance were computed across included studies. RESULTS: Of 80 initial studies identified, 5 studies (total of 265 patients and 1730 prostatic regions) met criteria for inclusion in the meta-analysis. Pooled sensitivity was 58.4% (95% confidence interval [CI], 53.5%-63.1%) for DWI and 55.3% (95% CI, 50.4%-60.1%) for DCE. Pooled specificity was 89.0% (95% CI, 87.2%-0.7%) for DWI and 87.9% (95% CI, 86.0%-89.6%) for DCE. At summary receiver-operating-characteristic analysis, area-under-the-curve was 0.810 (0.059) for DWI and 0.786 (0.079) for DCE. Heterogeneity across studies was high for sensitivity and specificity [inconsistency index (I), >90%], although heterogeneity of specificity was substantially improved after excluding an outlier study in terms of diagnostic threshold (I = 0.0%-68.8%). Relative performance of DWI and DCE remained similar after this exclusion CONCLUSIONS: There was a paucity of studies comparing DWI and DCE in the same patient cohorts, and heterogeneity among these studies was substantial. Nevertheless, performance of DWI and DCE was similar across identified studies, with both techniques showing substantially better specificity than sensitivity. Larger studies with uniform methodology are warranted to further understand relative merits of the 2 techniques.
KW - MRI
KW - diffusion-weighted imaging
KW - dynamic contrast-enhanced
KW - meta-analysis
KW - prostate cancer
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U2 - 10.1097/RCT.0b013e3182a3f9c7
DO - 10.1097/RCT.0b013e3182a3f9c7
M3 - Article
C2 - 24270122
AN - SCOPUS:84889046816
SN - 0363-8715
VL - 37
SP - 980
EP - 988
JO - Journal of Computer Assisted Tomography
JF - Journal of Computer Assisted Tomography
IS - 6
ER -