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  • Review Article
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Accuracy of SelectMDx compared to mpMRI in the diagnosis of prostate cancer: a systematic review and diagnostic meta-analysis

Prostate Cancer and Prostatic Diseases volume 25, pages 187–198 (2022)Cite this article

Subjects

Abstract

Background

The SelectMDx test is a promising biomarker that is developed based on detecting urinary messenger RNA in combination with clinical prostate cancer (PCa) risk factors. We aimed to compare SelectMDx and mpMRI as a diagnostic test in detecting PCa and high grade(HG)-PCa in men suspected to have PCa.

Methods

According to PRISMA, a systematic search was performed using major web databases for studies published before September 30, 2021. Studies that compared sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SelectMDx and/or mpMRI were included. The bivariate random model that plotted sensitivity, specificity, PPV, NPV, and likelihood ratio (LR) for PCa and HG-PCa detection was applied to compare SelectMDx, mpMRI, and combination strategies (both positive and one or both positive).

Results

Seven studies comprising 1328 patients who had undergone SelectMDx and mpMRI to detect PCa were included. Regarding PCa detection, SelectMDx had a pooled sensitivity of 81%, specificity of 69.8%, PPV of 64.7%, NPV of 85%, and LRs of +2.68 to −0.27, while mpMRI had a pooled sensitivity of 80.8%, specificity of 73.4%, PPV of 72.4%, NPV of 83.5%, and LRs of +3.03 to −0.26. The one or both positive strategy had the highest sensitivity (96.3%), NPV (95.7%), and the lowest -LR (0.06). While the both positive strategy had the highest specificity (80.9%), the PPV (76.5%) and +LR (3.68). In the scenario of PI-RADS 3 lesions not being biopsied in case of a negative SelectMDx (n = 44), unnecessary biopsies would be reduced by 42% (44/105) while the risk of missing HG-PCa would be 9% (4/44).

Conclusion

The performance of SelectMDx is comparable to that of mpMRI with regards to PCa and HG-PCa detection. In addition, this biomarker could help refine the clinical decision-making regarding the necessity of a biopsy in patients suspected to has been PCa.

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Fig. 1: The PRISMA diagram for study selection.
Fig. 2: Comparison between different strategies for prostate biopsy.
Fig. 3: The quality assessment for all included articles.
Fig. 4: Comparison between selectMDx and mpMRI for PCa detection.
Fig. 5: Summary receiver operating characteristic (SROC) curve for PCa diagnosis.
Fig. 6: Comparison between selectMDx and mpMRI for HG-PCa detection by primary biopsy.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge Dr Enrique Gómez Gómez from University Hospital/University of Cordoba/IMIBIC, Spain; Dr Mathieu Roumiguié from Institut Universitaire du Cancer, 31059 Toulouse, France; Dr J. Rubio-Briones from Instituto Valenciano de Oncología, Valencia, Spain; Dr Pietro Pepe from Cannizzaro Hospital, Italy; for their great attention to preparing supporting data for their study.

Author information

Authors and Affiliations

  1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Reza Sari Motlagh, Takafumi Yanagisawa, Tatsushi Kawada, Ekaterina Laukhtina, Pawel Rajwa, Abdulmajeed Aydh, Frederik König, Maximilan Pallauf, Nicolai A. Huebner, Pascal A. Baltzer, Axel Heidenreich & Shahrokh F. Shariat

  2. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Reza Sari Motlagh

  3. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan

    Takafumi Yanagisawa

  4. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Tatsushi Kawada

  5. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia

    Ekaterina Laukhtina & Shahrokh F. Shariat

  6. Department of Urology, Medical University of Silesia, Zabrze, Poland

    Pawel Rajwa

  7. Department of Urology, King Faisal Medical City, Abha, Saudi Arabia

    Abdulmajeed Aydh

  8. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Frederik König

  9. Department of Urology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria

    Maximilan Pallauf

  10. Working Group for Diagnostic imaging in Urology (ABDU), Austrian association of Urology (ÖGU), Vienna, Austria

    Nicolai A. Huebner

  11. Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria

    Pascal A. Baltzer

  12. Cancer Prognostics and Health outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada

    Pierre I. Karakiewicz

  13. Department of Urology, University Hospital Cologne, Cologne, Germany

    Axel Heidenreich

  14. Department of Urology, Weill Cornell Medical College, New York, NY, USA

    Shahrokh F. Shariat

  15. Department of Urology, University of Texas Southwestern, Dallas, TX, USA

    Shahrokh F. Shariat

  16. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic

    Shahrokh F. Shariat

  17. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria

    Shahrokh F. Shariat

  18. Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan

    Shahrokh F. Shariat

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  1. Reza Sari Motlagh
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Contributions

RSM, TY: Paper writing, Data analysis. TK, EL, PR, AA, FK, MP: Data collection. NAH, PAB: project development. PIK, AH, SFS: Paper editing.

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Correspondence to Shahrokh F. Shariat.

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Sari Motlagh, R., Yanagisawa, T., Kawada, T. et al. Accuracy of SelectMDx compared to mpMRI in the diagnosis of prostate cancer: a systematic review and diagnostic meta-analysis. Prostate Cancer Prostatic Dis 25, 187–198 (2022). https://doi.org/10.1038/s41391-022-00538-1

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