Meta-Analysis of the Diagnostic Accuracy of Multiparametric MRI in Prostate Cancer Detection

Abstract

Background: Prostate cancer is one of the most common malignancies in men, and early detection of clinically significant prostate cancer (csPCa) is crucial for improving outcomes. Multiparametric magnetic resonance imaging (mpMRI) has emerged as a transformative diagnostic tool, providing a non-invasive and precise approach for detecting csPCa.
Objective: This meta-analysis aimed to evaluate the diagnostic accuracy of mpMRI in detecting csPCa by synthesizing data from recent studies and examining factors influencing its performance.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases including PubMed, Embase, and Cochrane were searched for eligible studies from inception to December 2024. Inclusion criteria focused on original studies assessing mpMRI's sensitivity and specificity against histopathology as the reference standard. Statistical analyses were performed using bivariate random-effects models, with heterogeneity assessed via I² and funnel plots.
Results: Nine studies involving 2,161 patients were included. The pooled sensitivity and specificity of mpMRI for detecting csPCa were 86% and 88%, respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.91, demonstrating excellent diagnostic performance. Subgroup analyses revealed improved accuracy with 3T MRI systems and standardized PI-RADS v2.1 interpretation.
Conclusion: mpMRI demonstrates high sensitivity and specificity for csPCa detection, supporting its role as a first-line diagnostic tool. Further standardization and research are needed to optimize its implementation in clinical practice.