Accuracy of shear wave elastography for the diagnosis of prostate cancer: A meta-analysis

Abstract

Many studies have established the high diagnostic accuracy of shear wave elastography (SWE) for the detection of prostate cancer (PCa); however, its utility remains a subject of debate. This meta-analysis sought to appraise the overall accuracy of SWE for the detection of PCa. A literature search of the PubMed, Embase, Cochrane Library, Web of Science and CNKI (China National Knowledge Infrastructure) databases was conducted. In all of the included studies, the diagnostic accuracy of SWE was compared with that of histopathology, which was used as a standard. Data were pooled, and the sensitivity, specificity, area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to estimate the accuracy of SWE. The pooled sensitivity and specificity for the diagnosis of PCa by SWE were 0.844 (95% confidence interval: 0.696-0.927) and 0.860 (0.792-0.908), respectively. The AUC was 0.91 (0.89-0.94), the PLR was 6.017 (3.674-9.853), and the NLR was 0.182 (0.085-0.389). The DOR was 33.069 (10.222-106.982). Thus, SWE exhibited high accuracy for the detection of PCa using histopathology as a diagnostic standard. Moreover, SWE may reduce the number of core biopsies needed.

Figure 1

Literature search and selection scheme.

Figure 2

Forest plots of the diagnostic accuracy of SWE in PCa. A = Sensitivity; B = Specificity; C = Positive likelihood ratio; D = Negative likelihood ratio; E = Diagnostic odds ratio; CI = Confidence interval; LR = Likelihood ratio.

Figure 3

Summary receiver operating characteristic (SROC) curve for SWE in the diagnosis of PCa for all studies. AUC = Area under the curve.

Figure 4

Result of Bayesian analyses showing the pre- and post-test likelihoods for PCa detection. The pre-test probability is the probability of a PCa episode being detected without taking SWE into account. The post-test probability takes into account the results of SWE. LR = Likelihood ratio.

Figure 5

Funnel plot for the evaluation of potential publication bias. Each solid circle represents a study in the meta-analysis. The line is the regression line.