Korean Journal of Radiology

  • 제21권6호
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  • Pages.684-694
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  • 2020
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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The Diagnostic Performance of the Length of Tumor Capsular Contact on MRI for Detecting Prostate Cancer Extraprostatic Extension: A Systematic Review and Meta-Analysis

  • Tae-Hyung Kim (Department of Radiology, Seoul National University College of Medicine) ;
  • Sungmin Woo (Department of Radiology, Memorial Sloan-Kettering Cancer Center) ;
  • Sangwon Han (Department of Nuclear Medicine, Armed Forces Daejeon Hospital) ;
  • Chong Hyun Suh (Department of Radiology and Research Institute of Radiology, Asan Medical Center) ;
  • Soleen Ghafoor (Department of Radiology, Memorial Sloan-Kettering Cancer Center) ;
  • Hedvig Hricak (Department of Radiology, Memorial Sloan-Kettering Cancer Center) ;
  • Hebert Alberto Vargas (Department of Radiology, Memorial Sloan-Kettering Cancer Center)
  • 투고 : 2019.11.09
  • 심사 : 2020.02.09
  • 발행 : 2020.06.01
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초록

Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I2 (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

키워드

과제정보

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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