Korean J Radiol.  2008 Oct;9(5):432-438. 10.3348/kjr.2008.9.5.432.

A Meta-Analysis of the Accuracy of Prostate Cancer Studies Which Use Magnetic Resonance Spectroscopy as a Diagnostic Tool

• Wang P
• Guo YM
• Liu M
• Qiang YQ
• Guo XJ
• Zhang YL
• Duan XY
• Zhang QJ
• Liang W

• KMID: 1385402
• DOI: http://doi.org/10.3348/kjr.2008.9.5.432

Abstract

OBJECTIVE
We aimed to do a meta-analysis of the existing literature to assess the accuracy of prostate cancer studies which use magnetic resonance spectroscopy (MRS) as a diagnostic tool. MATERIALS AND METHODS: Prospectively, independent, blind studies were selected from the Cochrane library, Pubmed, and other network databases. The criteria for inclusion and exclusion in this study referenced the criteria of diagnostic research published by the Cochrane center. The statistical analysis was adopted by using Meta-Test version 6.0. Using the homogeneity test, a statistical effect model was chosen to calculate different pooled weighted values of sensitivity, specificity, and the corresponding 95% confidence intervals (95% CI). The summary receiver operating characteristic (SROC) curves method was used to assess the results. RESULTS: We chose two cut-off values (0.75 and 0.86) as the diagnostic criteria for discriminating between benign and malignant. In the first diagnostic criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI (expressed as area under curve [AUC]) were 0.82 (0.73, 0.89), 0.68 (0.58, 0.76), and 83.4% (74.97, 91.83). In the second criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI were 0.64 (0.55, 0.72), 0.86 (0.79, 0.91) and 82.7% (68.73, 96.68). CONCLUSION: As a new method in the diagnostic of prostate cancer, MRS has a better applied value compared to other common modalities. Ultimately, large scale RCT (randomized controlled trial) randomized controlled trial studies are necessary to assess its clinical value.

Keyword

Prostate carcinoma; Magnetic resonance (MR), spectroscopy; Meta-analysis; Summary receiver operating characteristic curve (SROC)

MeSH Terms

Humans
Magnetic Resonance Spectroscopy/*diagnostic use
Male
Prospective Studies
Prostatic Neoplasms/*diagnosis/metabolism
ROC Curve
Sensitivity and Specificity

Figure

• 

  Fig. 1 Forest plots of two groups of diagnostic criteria. A, B. First diagnostic criterion (A) second diagnostic criterion (B). Block plot mean values of sensitivity or 100-specificty. Transversal line cross plots represent the 95% CI. Shorter lines indicate that studies are more accurate. Bottom plots represent pooled weighted values.

• 

  Fig. 2 Summary receiver operating characteristic curve of first diagnostic criterion - 0.75. Area under curve represents accuracy of diagnosis. Larger area, greater level of accuracy. Area under curve is 83.4% (74.97, 91.83).

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  Fig. 3 Summary receiver operating characteristic curve of second diagnostic criterion - 0.86. Area under curve is 82.7% (68.73, 96.68).

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