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Meta-Analysis
. 2015 Apr;204(4):W439-48.
doi: 10.2214/AJR.14.13373.

Dynamic contrast-enhanced MRI for the detection of prostate cancer: meta-analysis

Cher Heng Tan  1 , Brian Paul Hobbs, Wei Wei, Vikas Kundra
Affiliations
Meta-Analysis

Dynamic contrast-enhanced MRI for the detection of prostate cancer: meta-analysis

Cher Heng Tan et al. AJR Am J Roentgenol. 2015 Apr.

Abstract

Objective: The purpose of this study was to systematically review and meta-analyze dynamic contrast-enhanced MRI (DCE-MRI) for the detection of prostate cancer in comparison with standard evaluation with T2-weighted imaging.

Materials and methods: A PubMed electronic database search for the terms "dynamic contrast-enhanced," "prostate," and "MRI" was completed for articles up to September 17, 2013. All included studies had histopathologic correlation. Two by two contingency data were constructed for each study. A binormal bayesian ROC model was used to estimate and compare sensitivity, specificity, and AUC among eligible modalities.

Results: Both DCE-MRI (0.82-0.86) and diffusion-weighted MRI (DWI) (0.84-0.88) yielded significantly better AUC than T2-weighted imaging (0.68-0.77). Moreover, partial AUC for the combination of DCE-MRI, DWI, and T2-weighted imaging was improved significantly (0.111; 0.103-0.119) when compared with DCE-MRI alone (0.079; 0.072-0.085) and T2-weighted imaging alone (0.079; 0.074-0.084) but not DWI alone (0.099; 0.091-0.108). Sensitivity and specificity were similar among the four modalities.

Conclusion: DCE-MRI improves AUC of tumor detection overall compared with T2-weighted imaging alone. Methods for DCE-MRI analysis require standardization, but visual analysis performs similar to semiquantitative methods. A two-parameter approach using DCE-MRI and T2-weighted imaging or DWI and T2-weighted imaging may be sufficient, and the latter may be more favorable for most routine prostate cancer imaging.

Keywords: MRI; cancer; dynamic contrast-enhanced MRI (DCE-MRI); prostate.

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Figures

Fig. 1
Fig. 1
ROC curves show each modality derived from combined data. DCE-MRI = dynamic contrast-enhanced MRI, DWI = diffusion-weighted MRI.
Fig. 2
Fig. 2
ROC curves show combined data. A–E, On graphs for dynamic contrast-enhanced (DCE-MRI) imaging (A); T2-weighted imaging (B); diffusion-weighted MRI (DWI) (C); combined T2-weighted and DCE-MRI (D); and combined T2-weighted, DWI, and DCE-MRI (E); each point represents contribution of single rater on basis of number of lesions evaluated.
Fig. 2
Fig. 2
ROC curves show combined data. A–E, On graphs for dynamic contrast-enhanced (DCE-MRI) imaging (A); T2-weighted imaging (B); diffusion-weighted MRI (DWI) (C); combined T2-weighted and DCE-MRI (D); and combined T2-weighted, DWI, and DCE-MRI (E); each point represents contribution of single rater on basis of number of lesions evaluated.
Fig. 3
Fig. 3
ROC curves show each modality for peripheral zone and transition zone only. DCE-MRI = dynamic contrast-enhanced MRI, DWI = diffusion-weighted MRI.
Fig. 4
Fig. 4
ROC curves show peripheral zone and transition zone data. A–D, On graphs for dynamic contrast-enhanced (DCE-MRI) imaging (A); T2-weighted imaging (B); diffusion-weighted MRI (DWI) (C); and combined T2-weighted, DWI, and DCE-MRI (D); each point represents contribution of single rater on basis of number of lesions evaluated.
Fig. 5
Fig. 5
ROC curves show visual versus semiquantitative assessment of dynamic contrast-enhanced MRI (DCE-MRI).
See this image and copyright information in PMC

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