Comparison of PET/MRI with multiparametric MRI in diagnosis of primary prostate cancer: A meta-analysis

Abstract

ObjectiveThis meta-analysis aimed to compare the diagnostic performance of positron emission tomography (PET)/MRI using various radiotracers with multiparametric (mp) MRI for detection of primary prostate cancer (PCa). MethodsA systematic literature search up to January 2019 was performed to identify studies that evaluated the diagnostic value of PET/MRI and mpMRI for detection of PCa in the same patient cohorts and had sufficient data to construct 2 × 2 contingency tables for true-positive (TP), false-positive (FP), false-negative (FN), and true-negative (TN) results. The quality of each study was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, and pooled sensitivity (SEN) and specificity (SPE) were calculated. Summary receiver operating characteristic (ROC) curves and area under the curves (AUCs) were used to compare the performances of PET/MRI and mpMRI. ResultsWe identified 9 eligible studies that included a total of 353 patients. PET/MRI had a SEN of 0.783 (95% CI, 0.758–0.807) and a SPE of 0.899 (95% CI, 0.879–0.917), and mpMRI had a SEN of 0.603 (95% CI, 0.574–0.631) and a SPE of 0.887 (95% CI, 0.866–0.906). PET/MRI had a higher AUC than mpMRI (0.9311, 95% CI, 0.8990–0.9632 vs. 0.8403, 95% CI, 0.7864–0.8942; P = 0.0036). There was no notable publication bias, but there was medium heterogeneity in outcomes. The meta-regression analysis showed the major potential cause of heterogeneity was the use of region-based rather than lesion-based analysis. ConclusionPET/MRI has very good diagnostic performance and outperforms mpMRI for the diagnosis of primary PCa.