Imaging features of the PI-RADS for predicting extraprostatic extension of prostate cancer: systematic review and meta-analysis

Insights into Imaging

Original Article

Young Joon Lee¹  Moon Hyung Choi¹  Dong Hwan Kim²  Sung Eun Rha²  Ji Youl Lee³ 

[1] Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 06591, Seoul, Republic of Korea;Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;

关键词: Prostatic neoplasms;    Neoplasm staging;    Magnetic resonance imaging;    Systematic review;    Meta-analysis;   

DOI  :  10.1186/s13244-023-01422-9

 received in 2023-03-08, accepted in 2023-04-05,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesTo systematically determine the diagnostic performance of each MRI feature of the PI-RADS for predicting extraprostatic extension (EPE) in prostate cancer.MethodsA literature search in the MEDLINE and EMBASE databases was conducted to identify original studies reporting the accuracy of each feature on MRI for the dichotomous diagnosis of EPE. The meta-analytic pooled diagnostic odds ratio (DOR), sensitivity, specificity, and their 95% confidence intervals (CIs) were obtained using a bivariate random-effects model.ResultsAfter screening 1955 studies, 17 studies with a total of 3062 men were included. All six imaging features, i.e., bulging prostatic contour, irregular or spiculated margin, asymmetry or invasion of neurovascular bundle, obliteration of rectoprostatic angle, tumor-capsule interface > 10 mm, and breach of the capsule with evidence of direct tumor extension, were significantly associated with EPE. Breach of the capsule with direct tumor extension demonstrated the highest pooled DOR (15.6, 95% CI [7.7–31.5]) followed by tumor-capsule interface > 10 mm (10.5 [5.4–20.2]), asymmetry or invasion of neurovascular bundle (7.6 [3.8–15.2]), and obliteration of rectoprostatic angle (6.1 [3.8–9.8]). Irregular or spiculated margin showed the lowest pooled DOR (2.3 [1.3–4.2]). Breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm showed the highest pooled specificity (98.0% [96.2–99.0]) and sensitivity (86.3% [70.0–94.4]), respectively.ConclusionsAmong the six MRI features of prostate cancer, breach of the capsule with direct tumor extension and tumor-capsule interface > 10 mm were the most predictive of EPE with the highest specificity and sensitivity, respectively.Graphical abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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