Elsevier

Academic Radiology

Volume 8, Issue 2, February 2001, Pages 149-157
Academic Radiology

Original investigation
Accuracy of MR imaging for staging prostate cancer: A meta-analysis to examine the effect of technologic change1

https://doi.org/10.1016/S1076-6332(01)90095-9Get rights and content

Rationale and Objectives.

The purpose of this study was to summarize the accuracy of magnetic resonance (MR) imaging for staging prostate cancer and to determine the effect of high magnetic field strength, use of the endorectal coil, use of fast spin-echo (SE) imaging, and study size on staging accuracy.

Materials and Methods.

A literature search and review yielded 27 studies comparing MR imaging to a pathologic standard in patients with clinically limited prostate cancer. Subgroup analyses examined magnetic field strength, use of an endorectal coil, use of fast SE imaging, publication date, and study size.

Results.

A summary receiver operating characteristic curve for all studies had a maximum joint sensitivity and specificity of 74%. At a specificity of 80% on this curve, sensitivity was 69%. Subgroup analyses showed that fast SE imaging was statistically significantly more accurate than conventional SE techniques (P < .001). Unexpectedly, studies employing higher magnetic field strength and those employing an endorectal coil were less accurate.

Conclusion.

Seemingly small technologic advances may influence test accuracy. Early and small studies, however, may overstate accuracy because of publication bias, bias in small samples, or earlier studies being performed by the experts who developed the technology itself.

References (37)

  • PoonPY et al.

    Magnetic resonance imaging of the prostate

    Radiology

    (1985)
  • PhillipsME et al.

    Prostatic disorders: MR imaging at 1.5 T

    Radiology

    (1987)
  • HricakH et al.

    Prostatic carcinoma: staging by clinical assessment, CT, and MR imaging

    Radiology

    (1987)
  • RifkinMD et al.

    Comparison of magnetic resonance imaging and ultrasonography in staging early prostate cancer: results of a multi-institutional cooperative trial

    N Engl J Med

    (1990)
  • CarrolCL et al.

    The abnormal prostate: MR imaging at 1.5 T with histopathologic correlation

    Radiology

    (1987)
  • SchnallMD et al.

    Prostate: MR imaging with an endorectal surface coil

    Radiology

    (1989)
  • ListerudJ et al.

    First principles of fast spin echo

    Magn Reson Q

    (1992)
  • WeingartS

    Acquiring advanced technology: decision making at twelve medical centers

    Int J Technol Assess Health Care

    (1993)
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    From the Consortium for Health Outcomes, Innovation and Cost-Effectiveness Studies (CHOICES), Department of Surgery, University of Michigan, 1500 E Medical Center Dr, 2110G Taubman Center, Ann Arbor, MI 48109-0346 (S.S.S.); and the Departments of Radiology, Epidemiology, and Computer and Information Science (C.P.L.) and the Leonard Davis Institute of Health Economics (J.S.S.), University of Pennsylvania, Philadelphia.

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