Diagnostic performance of MRI for prediction of muscle-invasiveness of bladder cancer: A systematic review and meta-analysis. Issue 95 (October 2017)

• Record Type: Journal Article
• Authors: Woo, Sungmin; Suh, Chong Hyun; Kim, Sang Youn; Cho, Jeong Yeon; Kim, Seung Hyup
• Is Part Of: European journal of radiology. Issue 95(2017)
• Page Start: 46
• Page End: 55
• Publication Date: 2017-10
• Subjects: MIBC muscle-invasive bladder cancer -- TUR transurethral resection -- MRI magnetic resonance imaging -- T1WI T1-weighted imaging -- T2WI T2-weighted imaging -- CE contrast-enhanced -- DWI diffusion-weighted imaging -- PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses -- QUADAS-2 Quality Assessment of Diagnostic Accuracy Studies-2 -- HSROC hierarchical summary receiver operating characteristic; Bladder cancer -- Muscle-invasive bladder cancer -- Local staging -- Magnetic resonance imaging -- Systematic review -- Meta-analysis; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2017.07.021
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To review the diagnostic performance of ≥1.5-T MRI for local staging of bladder cancer. Methods: MEDLINE and EMBASE were searched up to February 21, 2017. We included diagnostic accuracy studies published since 2000 that used ≥1.5-T MRI for local staging (≥T2 [muscle-invasive]) in patients with bladder cancer, using pathology as the reference standard. The methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled and plotted in a hierarchical summary receiver operating characteristics plot. Sensitivity analyses using several clinically relevant covariates were performed. Results: 24 studies (1774 patients) were included. Pooled sensitivity was 0.92 (95% CI 0.88–0.95) with specificity of 0.87 (95% CI 0.78–0.93). Sensitivity analyses showed that sensitivity estimates were comparable and consistently high across all subgroups, but specificity estimates were variable. Studies using 3-T scanners had higher specificity (0.93 [95% CI 0.86–0.98]) than those using 1.5-T scanners (0.83 [95% CI 0.74–0.98]). Studies using multiparametric MRI (conventional + ≥2 functional sequences) showed the highest accuracy with sensitivity and specificity of 0.94 (95% CI 0.89–1.00) and 0.95 (95% CI 0.89–0.98), respectively. Conclusions: MRI shows good diagnostic performance for predicting muscle-invasiveness of bladder cancer. Multiparametric 3-T MRI seems to improve both sensitivity and specificity.