Diagnostic value of 3.0 T versus 1.5 T MRI in staging prostate cancer: systematic review and meta-analysis

Abstract

Purpose: To compare the diagnostic performance of 3.0 T and 1.5 T MRI in the staging of prostate cancer.

Material and methods: English-language studies on the diagnostic accuracy of 3.0 T and 1.5 T MRI in prostate cancer staging published through May 2020 were searched for in relevant databases. The focus was on studies in which both 3.0 T and 1.5 T MRI were performed in the study population, to reduce interstudy heterogeneity. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve were determined for 3.0 T and for 1.5 T along with 95% confidence intervals (CIs).

Results: Out of 8 studies identified, 4 met the inclusion criteria. 3.0 T (n = 160) had a pooled sensitivity of 69.5% (95% CI: 56.4-80.1%) and a pooled specificity of 48.8% (95% CI: 6.0-93.4%), while 1.5 T (n = 139) had a pooled sensitivity of 70.6% (95% CI: 55.0-82.5%; p = 0.91) and a pooled specificity of 41.7% (95% CI: 6.2-88.6%; p = 0.88). The pooled DOR for 3.0 T was 3 (95% CI: 0-26.0%), while the pooled DOR for 1.5 T was 2 (95% CI: 0-18.0%), which was not a significant difference (p = 0.89).

Conclusions: 3.0 T has slightly better diagnostic performance than 1.5 T MRI in prostate cancer staging (3 vs. 2), although without statistical significance. Our findings suggest the need for larger, randomized trials directly comparing 3.0 T and 1.5 T MRI in prostate cancer.

Keywords: 1.5 T; 3.0 T; meta-analysis; prostate cancer.

Figure 1

A-D) A 78-year-old man with prostate adenocarcinoma, Gleason score 6 (3 + 3). A) Axial T2-weighted imaging, (B) diffusion-weighted image (b = 800 s/mm²), (C) apparent diffusion coefficient, and (D) post-contrast T1-weighted imaging of 1.5 T MRI show a 1.5 × 0.9 cm dominant lesion in the right peripheral zone at the level of the mid-gland near the apex (arrow) with low T2 signal, restricted diffusion, and post-contrast enhancement. Qualitative suspicion of clinically significant disease: 5. E-H) A 59-year-old man with prostate adenocarcinoma, Gleason score 7 (4 + 3). E) Axial T2-weighted imaging, (F) diffusion-weighted image (b = 800 s/mm²), (G) apparent diffusion coefficient, and (H) post-contrast T1-weighted imaging of 3 T MRI show a 1.1 × 1.0 cm dominant lesion located in the right peripheral zone at the level of the mid-gland (arrow) with low T2 signal, restricted diffusion, and post-contrast enhancement. Qualitative suspicion of clinically significant disease: 5. *Endorectal coil

Figure 2

Preferred Reporting Items for Systematic Reviews (PRISMA) flow diagram of the meta-analysis

Figure 3

Methodologic quality of all eligible studies according to the domains of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool

Figure 4

Summary receiver operating characteristic curve for 3.0 T. Red diamond represents pooled sensitivity and specificity, while surrounding blue region represents the 95% confidence region around this estimate. Green triangles represent individual study estimates. The area under the summary receiver operating characteristic curve was 0.842

Figure 5

Summary receiver operating characteristic curve for 1.5 T. Red diamond represents pooled sensitivity and specificity, while the surrounding blue region represents the 95% confidence region around this estimate. Green triangles represent individual study estimates. The area under the summary receiver operating characteristic curve was 0.845