Diagnostic Accuracy of Multiparametric MRI for Clinically Significant Prostate Cancer: A Systematic Review and Meta-Analysis
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Abstract
Background: Prostate cancer is still a primary cause of male cancer morbidity and mortality. Multiparametric MRI (mpMRI), based on PI-RADS interpretation, has become invaluable in the diagnosis of clinically significant prostate cancer (csPCa). Aim and Objective: To determine the diagnostic accuracy of mpMRI to identify csPCa when categorized based on cut-offs of PI-RADS score (≥3 and ≥4), and to examine consistency of reported results between and across studies and study-level heteroscedasticity. Methods: A systematic review and meta-analysis of PRISMA 2020 guidelines, including studies from 2017 to 2025, were undertaken. Ten studies that fulfilled the inclusion criterion, of which seven supplied quantitative data, were noted. Random effects models were used to calculate pooled sensitivity, specificity, and diagnostic odds ratio. Meta-regression was also undertaken to examine the relationship between effect size and standard error. Results: Pooled sensitivity for detection of csPCa was 0.84 (95% CI 0.80-0.88) and specificity was 0.72 (95% CI 0.66-0.78) at PI-RADS ≥ 4, and the AUC was 0.89. For PI-RADS ≥ 3, sensitivity became higher as 0.94, but specificity became lower as 0.45. Conclusion: The mpMRI enjoys high sensitivity and acceptable overall diagnostic effectiveness for the visualization of csPCa. Prospective advances that blend AI, Artificial General Intelligence, and multimodal data synthesis are likely to redefine prostate MRI from interpretive imaging to smart, precision-guided diagnosis.
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Copyright (c) 2025 Vijayakumar Chinnasamy, Sanul Shahi K Salim, Nadha Rahim, Noula Rahim, Jamila Hameed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Vijayakumar Chinnasamy, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Sanul Shahi K Salim, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Nadha Rahim, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Noula Rahim, Department of Biochemistry, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Biochemistry, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Jamila Hameed, Research Mentor, Department of OBG, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Research Mentor, Department of OBG, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
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