A meta-analysis for assessing the value of MR spectroscopy in the diagnosis of prostate cancer

摘要

Objective: To assess the value of MR spectroscopy (MRS) in the diagnosis of prostate cancer by meta-analysis. Methods: Prospective studies were selected from the MEDLINE, Ovid, Embase databases, Springer, Elsevier, China National Knowledge Infrastructure. According to the suggestion, results were determined by the ratio of (Cho+Cr)/Cit . If this ratio was less than 0. 75, negative result was respectively determined, and the definitive tumor was diagnosed as this threshold. According to the assessment standard of Evidence-based Medicine, English and Chinese literature in Grade A and B on MRS imaging was included. According to homogeneity test, different effect models were chosen to calculate different pooled weighted values of sensitivity, specificity and the corresponding 95% confidence intervals (95% CI). Summary receiver operating characteristic (SROC) curves were used to assess the results. Funnel plot was used to analyze publication bias. Results: According to the assessment standard of Evidence-based Medicine, only 5 papers in Grade B were included in this research. The pooled weighted sensitivity and its 95% confidence interval is 82% (73%, 89%) and the pooled weighted sensitivity and its 95% confidence interval is 68% (58% , 76% ). The AUC (area under curve) is 83. 40%. An asymmetric funnel plot suggested two missing studies leading to publication bias. Conclusion: If the ratio of (Cho + Cr)/Cit is regarded as the diagnostic criteria in detecting prostate cancer by MRS, meta-analysis suggests this method has a better diagnostic value to detect the malignant prostate mass but the sensitivity needs to be improved. We hope to support a method and requirement about diagnostic test. Performing perspective register and improving quality of study design is the only way to reduce the bias and get real information of disease.