Evidence map›Paper›PMID 31869380›Full record

ArticlePloS one2019

The role of gadolinium in magnetic resonance imaging for early prostate cancer diagnosis: A diagnostic accuracy study.

Ilinca Cosma, Cornelia Tennstedt-Schenk, Sven Winzler, Marios Nikos Psychogios, Alexander Pfeil, Ulf Teichgraeber, Ansgar Malich, Ismini Papageorgiou

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Ilinca CosmaInstitute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany.
Cornelia Tennstedt-SchenkInstitute for Pathology, Muehlhausen, Germany.
Sven WinzlerInstitute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany.
Marios Nikos PsychogiosDepartment of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Alexander PfeilDepartment of Internal Medicine, University Hospital Jena, Jena, Germany.
Ulf TeichgraeberInstitute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany.
Ansgar MalichInstitute of Radiology, Suedharz Hospital Nordhausen, Nordhausen, Germany.
Ismini PapageorgiouInstitute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany.ORCID 0000-0001-5810-0483
Jena University Hospital · DESüdharz Klinikum · DEUniversity Hospital of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveProstate lesions detected with multiparametric magnetic resonance imaging (mpMRI) are classified for their malignant potential according to the Prostate Imaging-Reporting And Data System (PI-RADS™2). In this study, we evaluate the diagnostic accuracy of the mpMRI with and without gadolinium, with emphasis on the added diagnostic value of the dynamic contrast enhancement (DCE). MATERIALS AND

methodsThe study was retrospective for 286 prostate lesions / 213 eligible patients, n = 116/170, and 49/59% malignant for the peripheral (Pz) and transitional zone (Tz), respectively. A stereotactic MRI-guided prostate biopsy served as the histological ground truth. All patients received a mpMRI with DCE. The influence of DCE in the prediction of malignancy was analyzed by blinded assessment of the imaging protocol without DCE and the DCE separately.

resultsSignificant (CSPca) and insignificant (IPca) prostate cancers were evaluated separately to enhance the potential effects of the DCE in the detection of CSPca. The Receiver Operating Characteristics Area Under Curve (ROC-AUC), sensitivity (Se) and specificity (Spe) of PIRADS-without-DCE in the Pz was 0.70/0.47/0.86 for all cancers (IPca and CSPca merged) and 0.73/0.54/0.82 for CSPca. PIRADS-with-DCE for the same patients showed ROC-AUC/Se/Spe of 0.70/0.49/0.86 for all Pz cancers and 0.69/0.54/0.81 for CSPca in the Pz, respectively, p>0.05 chi-squared test. Similar results for the Tz, AUC/Se/Spe for PIRADS-without-DCE was 0.75/0.61/0.79 all cancers and 0.67/0.54/0.71 for CSPca, not influenced by DCE (0.66/0.47/0.81 for all Tz cancers and 0.61/0.39/0.75 for CSPca in Tz). The added Se and Spe of DCE for the detection of CSPca was 88/34% and 78/33% in the Pz and Tz, respectively.

conclusionDCE showed no significant added diagnostic value and lower specificity for the prediction of CSPca compared to the non-enhanced sequences. Our results support that gadolinium might be omitted without mitigating the diagnostic accuracy of the mpMRI for prostate cancer.

Indexed as

AgedArea Under CurveContrast MediaEarly Detection of CancerGadoliniumHumansImage-Guided BiopsyMaleMiddle AgedMultiparametric Magnetic Resonance ImagingProstateProstatic NeoplasmsROC CurveContrast MediaGadolinium

Identifiers

PMID31869380
PMCPMC6927639
OpenAlexW2994777531

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.