Abbreviated Biparametric Versus Standard Multiparametric MRI for Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis

Abstract

The objective of our study was to evaluate the diagnostic accuracy of abbreviated biparametric MRI (bpMRI) versus standard multiparametric MRI (mpMRI) for prostate cancer (PCa) using guided biopsy or prostatectomy histopathology results as the reference standard. A comprehensive literature search of PubMed, Web of Science, and Cochrane Library databases was performed by two researchers independently and the relevant references were assessed. Original research studies comparing bpMRI with mpMRI in diagnosing PCa were included. The methodologic quality of eligible studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data necessary to complete 2 × 2 contingency tables were obtained to calculate the diagnostic performance of bpMRI and mpMRI using Stata (version 14). Ten studies were included, and a total of 1705 patients and 3419 lesions were analyzed. Sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio (DOR) of mpMRI in diagnosing PCa were 0.79 (95% CI, 0.69-0.87), 0.89 (95% CI, 0.70-0.96), 6.9 (95% CI, 2.5-18.8), 0.24 (95% CI, 0.16-0.35), and 29 (95% CI, 10-83). Sensitivity, specificity, positive LR, negative LR, and DOR of bpMRI in diagnosing PCa were 0.79 (95% CI, 0.69-0.87), 0.88 (95% CI, 0.73-0.95), 6.4 (95% CI, 2.9-14.5), 0.24 (95% CI, 0.16-0.35), and 27 (95% CI, 11-67). Meta-analysis showed no statistically significant difference between bpMRI and mpMRI for the diagnosis of PCa, and the areas under the summary ROC (SROC) curves were 0.89 and 0.88, respectively (p = 0.9944). Results of the sensitivity analysis were consistent, and the area under the SROC curve for bpMRI and mpMRI was 0.89 for both (p = 0.9349). The available evidence indicates that bpMRI and mpMRI have similar diagnostic efficacy in diagnosing PCa.