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Abstract

Background

The diagnostic accuracy of diffusion-weighted imaging (DWI) to detect prostate cancer is well-established. DWI provides visual as well as quantitative means of detecting tumor, the apparent diffusion coefficient (ADC). Recently higher b-values have been used to improve DWI’s diagnostic performance.

Purpose

To determine the diagnostic performance of high b-value DWI at detecting prostate cancer and whether quantifying ADC improves accuracy.

Material and Methods

A comprehensive literature search of published and unpublished databases was performed. Eligible studies had histopathologically proven prostate cancer, DWI sequences using b-values ≥ 1000 s/mm², less than ten patients, and data for creating a 2 × 2 table. Study quality was assessed with QUADAS-2 (Quality Assessment of diagnostic Accuracy Studies). Sensitivity and specificity were calculated and tests for statistical heterogeneity and threshold effect performed. Results were plotted on a summary receiver operating characteristic curve (sROC) and the area under the curve (AUC) determined the diagnostic performance of high b-value DWI.

Results

Ten studies met eligibility criteria with 13 subsets of data available for analysis, including 522 patients. Pooled sensitivity and specificity were 0.59 (95% confidence interval [CI], 0.57–0.61) and 0.92 (95% CI, 0.91–0.92), respectively, and the sROC AUC was 0.92. Subgroup analysis showed a statistically significant (P = 0.03) improvement in accuracy when using tumor visual assessment rather than ADC.

Conclusion

High b-value DWI gives good diagnostic performance for prostate cancer detection and visual assessment of tumor diffusion is significantly more accurate than ROI measurements of ADC.

Keywords

Prostate cancer magnetic resonance imaging MRI diffusion-weighted imaging DWI high-b-value meta-analysis

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Accuracy of high b-value diffusion-weighted MRI for prostate cancer detection: a meta-analysis

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material