title: Usefulness of diffusion-weighted magnetic resonance imaging in the diagnosis of prostate cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) in prostate cancer.
  
  
  METHODS
  The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases were searched for studies published from January 2001 to August 2011 evaluating the diagnostic performance of DWI in detecting prostate carcinoma. Sensitivities and specificities were determined across studies, and summary receiver-operating characteristic curves were constructed using hierarchical regression models.
  
  
  RESULTS
  Sixteen studies (18 subsets) with a total of 852 patients were included. Six studies (seven subsets) examining men with pathologically confirmed prostate cancer (260 patients) had pooled sensitivity and specificity of 0.88 (95% confidence interval [CI], 0.76-0.95) and 0.84 (95% CI, 0.76-0.90), respectively. Compared to patients at high risk for clinically relevant cancer, sensitivity was higher in low-risk patients (0.94 [95% CI, 0.89-0.97] vs 0.62 [95% CI, 0.54-0.70], P < .05), but specificity was lower (0.86 [95% CI, 0.72-0.94] vs 0.89 [95% CI, 0.83-0.93], P < .05). Ten studies (11 subsets) examining patients with suspected prostate cancer (592 patients) had pooled sensitivity and specificity of 0.76 (95% CI, 0.68-0.84) and 0.86 (95% CI, 0.79-0.91). Sensitivity was lower in high-risk patients (0.74 [95% CI, 0.57-0.87] vs 0.78 [95% CI, 0.70-0.84], P > .05), but specificity was higher (0.92 [95% CI, 0.89-0.94] vs 0.78 [95% CI, 0.70-0.84], P < .05).
  
  
  CONCLUSIONS
  A limited number of small studies suggest that DWI could be a rule-in test for high-risk patients. Further prospective studies including larger populations are necessary to confirm the actual value of DWI in this field.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No 1630, Dongfang Road, Pudong, Shanghai 200127, China.
authors.forename: Lian-Ming
authors.initials: LM
authors.lastname: Wu
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Xu
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Gu
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Jiong
authors.initials: J
authors.lastname: Zhu
authors.forename: Yong-Quan
authors.initials: YQ
authors.lastname: Ye
authors.forename: Jiani
authors.initials: J
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D018570:Risk Assessment