The clinical value of diffusion-weighted imaging in combination with T2-weighted imaging in diagnosing prostate carcinoma: a systematic review and meta-analysis.
OBJECTIVE
We aimed to explore the role of diffusion-weighted imaging (DWI) in combination with T2-weighted imaging (T2WI) in detecting prostate carcinoma through a systematic review and meta-analysis.


METHODS
The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched for studies published from January 2001 to July 2011 evaluating the diagnostic performance of T2WI combined with DWI in detecting prostate carcinoma. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic curves. We also compared the performance of T2WI combined with DWI with T2WI alone by analyzing studies that had also used these diagnostic methods on the same patients.


RESULTS
Across 10 studies (627 patients), the pooled sensitivity of T2WI combined with DWI was 0.76 (95% CI, 0.65-0.84), and the pooled specificity was 0.82 (95% CI, 0.77-0.87). Overall, the positive likelihood ratio was 4.31 (95% CI, 3.12-5.92), and the negative likelihood ratio was 0.29 (95% CI, 0.20-0.43). In seven studies in which T2WI combined with DWI and T2WI alone were performed, the sensitivity and specificity of T2WI combined with DWI were 0.72 (95% CI, 0.67-0.82) and 0.81 (95% CI, 0.76-0.86), respectively, and the sensitivity and specificity of T2WI alone were 0.62 (95% CI, 0.55-0.68) and 0.77 (95% CI, 0.71-0.82), respectively.


CONCLUSIONS
T2WI combined with DWI may be a valuable tool for detecting prostate cancer in the overall evaluation of prostate cancer, compared with T2WI alone. High-quality prospective studies of T2WI combined with DWI to detect prostate carcinoma still need to be conducted.
Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Rd, Pudong, Shanghai 200127, China.
Lian-Ming
LM
Wu
Jian-Rong
JR
Xu
Yong-Quan
YQ
Ye
Qing
Q
Lu
Jia-Ni
JN
Hu
D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity