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Background <p>Prostate cancer (PCa) is a well-known cancer that is frequently diagnosed in men and a significant cause of cancer morbidity and mortality on a global scale. Clinical significant prostate cancer (csPCa) is a concern that requires early diagnosis in order to maximize treatment and minimize overtreatment. Traditional diagnostic tools, which are prostate-specific antigen (PSA) and systematic transrectal ultrasound (TRUS)-guided biopsy, are limited in nature in the form of low specificity and sampling errors. Multiparametric MRI (mpMRI) has become a potentially effective non-invasive method to enhance detection and targeted biopsies.</p> Objective <p>To determine the diagnostic accuracy of mpMRI in detecting csPCa within a meta-analysis of both prospective and retrospective analyses.</p> Methods <p>The literature search was performed in the databases of PubMed, Embase, Web of Science, Scopus, and Cochrane Library until March 2026. Articles that provided diagnostic results of mpMRI or biparametric MRI (bpMRI) that were confirmed by histopathology were incorporated. Bivariate random-effects model was used to conduct data extraction, quality assessment (QUADAS-2) and statistical pooling.</p> Results <p>The number of studies involved was 23 with 8,000 or more participants. mpMRI sensitivity was pooled and was 93.3% (95% CIs: 87.6–96.4%), and specificity of 57.5% (95% CIs: 45.1–69.0%). The odds ratio of the diagnostic was 18.75 and the likelihood ratio was negative 0.12. The level of heterogeneity was high (I<sup>2</sup> = 95%). The results indicate high sensitivity in the elimination of csPCa but moderate specificity reveals the need to interpret the results with care.</p> Conclusion <p>mpMRI is very sensitive in the detection of csPCa and it is effective in eliminating unnecessary biopsies. The further improvement of diagnostic performance and patient management is possible with the help of standardized imaging protocols, radiologist experience, and incorporation of advanced techniques.</p>

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Diagnostic Accuracy of Multiparametric MRI for Prostate Cancer Detection: A Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Shehzad Yousaf,
  • Syed Muhammad Yousaf Farooq,
  • Muhammad Moazzam,
  • Muhammad Farrukh Asif,
  • Yasmeen Niazi,
  • Saima Bilal

摘要

Background

Prostate cancer (PCa) is a well-known cancer that is frequently diagnosed in men and a significant cause of cancer morbidity and mortality on a global scale. Clinical significant prostate cancer (csPCa) is a concern that requires early diagnosis in order to maximize treatment and minimize overtreatment. Traditional diagnostic tools, which are prostate-specific antigen (PSA) and systematic transrectal ultrasound (TRUS)-guided biopsy, are limited in nature in the form of low specificity and sampling errors. Multiparametric MRI (mpMRI) has become a potentially effective non-invasive method to enhance detection and targeted biopsies.

Objective

To determine the diagnostic accuracy of mpMRI in detecting csPCa within a meta-analysis of both prospective and retrospective analyses.

Methods

The literature search was performed in the databases of PubMed, Embase, Web of Science, Scopus, and Cochrane Library until March 2026. Articles that provided diagnostic results of mpMRI or biparametric MRI (bpMRI) that were confirmed by histopathology were incorporated. Bivariate random-effects model was used to conduct data extraction, quality assessment (QUADAS-2) and statistical pooling.

Results

The number of studies involved was 23 with 8,000 or more participants. mpMRI sensitivity was pooled and was 93.3% (95% CIs: 87.6–96.4%), and specificity of 57.5% (95% CIs: 45.1–69.0%). The odds ratio of the diagnostic was 18.75 and the likelihood ratio was negative 0.12. The level of heterogeneity was high (I2 = 95%). The results indicate high sensitivity in the elimination of csPCa but moderate specificity reveals the need to interpret the results with care.

Conclusion

mpMRI is very sensitive in the detection of csPCa and it is effective in eliminating unnecessary biopsies. The further improvement of diagnostic performance and patient management is possible with the help of standardized imaging protocols, radiologist experience, and incorporation of advanced techniques.