Diagnostic performance of MRI for prediction of muscle-invasiveness of bladder cancer: A systematic review and meta-analysis |
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Institution: | 1. Laboratory of Epigenetics, Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;2. Department of Pathology, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea;3. Department of Pathology, and Seoul National University College of Medicine, Seoul 03080, Republic of Korea;1. Clinical Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea;2. Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul 110-744, Republic of Korea;3. Department of Psychiatry and Behavioral Science, Seoul National University, College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea |
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Abstract: | PurposeTo review the diagnostic performance of ≥1.5-T MRI for local staging of bladder cancer.MethodsMEDLINE 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.Results24 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.ConclusionsMRI shows good diagnostic performance for predicting muscle-invasiveness of bladder cancer. Multiparametric 3-T MRI seems to improve both sensitivity and specificity. |
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Keywords: | Bladder cancer Muscle-invasive bladder cancer Local staging Magnetic resonance imaging Systematic review Meta-analysis |
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