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Role of multiparametric magnetic resonance imaging for patients under active surveillance for prostate cancer: a systematic review with diagnostic meta-analysis

Prostate Cancer and Prostatic Diseases volume 22, pages 206–220 (2019)Cite this article

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Abstract

Background

The use of multiparametric magnetic resonance imaging (mpMRI) in the setting of patients under active surveillance (AS) is promising. In this systematic-review we aimed to analyse the role of mpMRI in patients under AS.

Methods

A comprehensive literature research for English-language original and review articles, recently published, was carried out using Medline, Scopus and Web of sciences databases until 30 October 2017. The following MeSH terms were used: 'active surveillance', 'prostate cancer', 'multiparametric magnetic resonance imaging'. A diagnostic meta-analysis was performed for 3.0 T mpMRI in predicting disease re-classification.

Results

In total, 226 studies were selected after research and after removal of duplicates. After analysis on inclusion criteria, 43 studies were identified as eligible for this systematic review with a total of 6,605 patients. The timing of MRI during follow-up of AS differed from all studies like criteria for inclusion in the AS protocol. Overall, there was a low risk of bias across all studies. The diagnostic meta-analysis for 1.5 tesla showed a sensitivity of 0.60, negative predictive value (NPV) of 0.75 and a hierarchical summary receiving operating curve (HSROC) of 0.74 while for 3.0 tesla mpMRI a sensitivity of 0.81, a NPV of 0.78 and a HSROC of 0.83.

Conclusions

Overall, the available evidence suggests that both 1.5 or 3.0 Tesla mpMRI are a valid tool to monitor progression during AS follow-up, showing good accuracy capabilities in detecting PCa re-classification. However, the modality to better define what means 'disease progression' on mpMRI must be further evaluated.

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Author contributions

FC: Project development, data collection, manuscript writing. GIR: Project development, data collection, statistical analysis manuscript writing. SK: manuscript writing. GC: manuscript writing. MF: data collection. ODC: project development. WA: project development. GM: project development. RD: project development. KN: project development. NK: project development. AS: project development. JB: Project development, data collection, manuscript writing. SK: Project development, data collection, manuscript writing.

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  1. These authors contributed equally: Francesco Cantiello, Giorgio Ivan Russo.

Authors and Affiliations

  1. Department of Urology, University Magna Graecia of Catanzaro, Catanzaro, Italy

    Francesco Cantiello, Fabio Crocerossa & Rocco Damiano

  2. Urology Section, Department of Surgery, University of Catania, Catania, Italy

    Giorgio Ivan Russo, Sebastiano Cimino & Giuseppe Morgia

  3. Department of Urology, Eberhard Karls University of Tuebingen, Tuebingen, Germany

    Sascha Kaufmann, Walter Artibani & Konstantin Nikolaou

  4. Department of Urology, University of Verona, Verona, Italy

    Giovanni Cacciamani

  5. Department of Urology, European Institute of Oncology, Milan, Italy

    Matteo Ferro & Ottavio De Cobelli

  6. Department of Urology, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany

    Nils Kröger

  7. Diagnostic and Interventional Radiology, Eberhard Karls University of Tuebingen, Tuebingen, Germany

    Arnulf Stenzl, Jens Bedke & Stephan Kruck

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Cantiello, F., Russo, G.I., Kaufmann, S. et al. Role of multiparametric magnetic resonance imaging for patients under active surveillance for prostate cancer: a systematic review with diagnostic meta-analysis. Prostate Cancer Prostatic Dis 22, 206–220 (2019). https://doi.org/10.1038/s41391-018-0113-2

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