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European Radiology

, Volume 27, Issue 12, pp 5204–5214 | Cite as

A meta-analysis of use of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2) with multiparametric MR imaging for the detection of prostate cancer

  • Li Zhang
  • Min Tang
  • Sipan Chen
  • Xiaoyan Lei
  • Xiaoling Zhang
  • Yi Huan
Urogenital

Abstract

Objectives

This meta-analysis was undertaken to review the diagnostic accuracy of PI-RADS V2 for prostate cancer (PCa) detection with multiparametric MR (mp-MR).

Methods

A comprehensive literature search of electronic databases was performed by two observers independently. Inclusion criteria were original research using the PI-RADS V2 system in reporting prostate MRI. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data necessary to complete 2 × 2 contingency tables were obtained from the included studies.

Results

Thirteen studies (2,049 patients) were analysed. This is an initial meta-analysis of PI-RADs V2 and the overall diagnostic accuracy in diagnosing PCa was as follows: pooled sensitivity, 0.85 (0.78–0.91); pooled specificity, 0.71 (0.60–0.80); pooled positive likelihood ratio (LR+), 2.92 (2.09–4.09); pooled negative likelihood ratio (LR–), 0.21 (0.14–0.31); pooled diagnostic odds ratio (DOR), 14.08 (7.93–25.01), respectively. Positive predictive values ranged from 0.54 to 0.97 and negative predictive values ranged from 0.26 to 0.92.

Conclusion

Currently available evidence indicates that PI-RADS V2 appears to have good diagnostic accuracy in patients with PCa lesions with high sensitivity and moderate specificity. However, no recommendation regarding the best threshold can be provided because of heterogeneity.

Key Points

PI-RADS V2 shows good diagnostic accuracy for PCa detection.

Initially pooled specificity of PI-RADS v2 remains moderate.

PCa detection is increased by experienced radiologists.

There is currently a high heterogeneity in prostate diagnostics with MRI.

Keywords

Prostate cancer Magnetic resonance imaging PI-RADS V2 Diagnosis Meta-analysis 

Abbreviations

95% CI

95% confidence interval

AUC

Area under the SROC curve

DCE

Dynamic contrast-enhanced

DOR

Diagnostic odds ratio

DWI

Diffusion-weighted imaging

ESUR

European Society of Urogenital Radiology

FN

False negative

FP

False positive

LR–

Negative likelihood ratio

LR+

Positive likelihood ratio

mp-MRI

Multiparametric MR

MRS

MR proton spectroscopy

PCa

Prostate cancer

PI-RADS V2

Prostate Imaging Reporting and Data System Version 2

PRISMA

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

PSA

Prostate-specific antigen

PZ

Peripheral zone

QUADAS-2

Quality Assessment of Diagnostic Accuracy Studies

SROC

Summary receiver-operating curve

TN

True negative

TP

True positive

TZ

Transitional zone assessment

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Guarantor name: Zhang xiaoling zxl.822@163.com

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because this study is a meta- analysis.

Ethical approval

Institutional Review Board approval was not required because this study is a meta- analysis.

Methodology: diagnostic or prognostic study

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Li Zhang
    • 1
    • 2
  • Min Tang
    • 2
  • Sipan Chen
    • 1
    • 2
  • Xiaoyan Lei
    • 2
  • Xiaoling Zhang
    • 2
  • Yi Huan
    • 1
  1. 1.Department of Radiology, Xijing HospitalFourth Military Medical UniversityXi’anChina
  2. 2.Department of MRIShaanxi Provincial People’s HospitalXi’anChina

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