Abstract

Purpose: Evaluate the diagnostic accuracy of multi-parametric magnetic resonance imaging (mp-MRI) for local staging of bladder cancer (BCa).Materials and Methods: The databases of PubMed, Web of Science, Wanfang, and CNKI were searched for related literatures about BCa diagnosed by mp-MRI from January 1, 2000 to April 12, 2019. The strict inclusion and exclusion criteria were set up to extract records. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was used to evaluate quality of the candidate studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (−LR), and diagnostic odds ratio (DOR) were calculated to assess the diagnostic authenticity of mp-MRI. The summarized receiver operating characteristic (SROC) curve corresponding with the area under the curve (AUC) were analyzed to comprehensively evacuate the diagnostic value of mp-MRI.Results: A total of 140 studies were retrieved by computer-based searching. After quality control, 4 studies with 259 patients were enrolled for meta-analysis. The pooled results showed 0.84 of sensitivity [95% confidence interval (CI) = 0.79-0.89], 0.91 of specificity (95% CI = 0.87–0.93), 8.24 of +LR (95% CI = 4.87–13.92), 0.18 of –LR (95% CI = 0.10–0.31), 49.42 of DOR (95% CI = 19.07–128.09), and 0.946 of AUC. The Spearman correlation analysis found no threshold effect (p = 0.684). A significant heterogeneity existed among 4 included studies with sensitivity (I2 = 65.7%), specificity (I2 = 60.0%) and diagnostic OR (I2 = 67.5%). The Begg's test (p = 0.497) and the egger's test (p = 0.337) found no publication bias.Conclusion: mp-MRI acts a good diagnostic performance for bladder cancer. It is plausible that mpMRIs can be used as an important method for bladder cancer staging.

Highlights

  • Bladder cancer is one of the most common cancers worldwide with nearly 550,000 new cases diagnosed in 2018 and around 200,000 patients die from this disease

  • The pooled results showed 0.84 of sensitivity [95% confidence interval (CI) = 0.79-0.89], 0.91 of specificity, 8.24 of +negative likelihood ratio (LR), 0.18 of –LR, 49.42 of diagnostic odds ratio (DOR), and 0.946 of area under the curve (AUC)

  • The computer search was performed among the databases of PubMed, Web of Science, Wanfang, and CNKI with the search terms including (“bladder cancer” OR “BCa” OR “bladder carcinoma” OR “urinary bladder neoplasms”) AND (“mp-MRI” OR “multi-parametric magnetic resonance imaging” OR “multiparametric MRI” OR “MRI” OR “magnetic resonance imaging”) AND (“staging” OR “stage”) AND (“diagnosis” OR “diagnose”-)

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Summary

Introduction

Bladder cancer is one of the most common cancers worldwide with nearly 550,000 new cases diagnosed in 2018 and around 200,000 patients die from this disease. The multi-parametric magnetic resonance imaging (mp-MRI) is widely used for bladder cancer diagnosis and staging. It consists of the conventional sequence [T2-weighted anatomic imaging (T2WI)] and functional MRI techniques [dynamic contrast-enhanced (DCE) imaging and diffusionweighted imaging (DWI)] [4]. Multi-parametric magnetic resonance imaging has the high sensitivity and specificity in diagnosing and staging the bladder cancer. It can provide more information about the morphology of bladder and the blood supply, so it is helpful for preoperative diagnosis of bladder cancer [4]. Several studies have assessed the diagnosis value of mp-MRI in staging bladder cancer, the sensitivity and specificity of each study were not in accordance

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