ArticleInsights into imaging2024
Diagnostic performance of MRI in detecting prostate cancer in patients with prostate-specific antigen levels of 4-10 ng/mL: a systematic review and meta-analysis.
Article in Insights into imaging, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Diagnostic performance of AI-powered prostate MRI against biopsy ground truth: quasi-continuous risk scoring versus fixed PI-RADS thresholds.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
- Stratified Analysis of Patients Within the PSA Gray Zone (4-10 ng/mL) and Its Clinical Application Value: Development of a Predictive Model for Clinically Significant Prostate Cancer Using Quantitative Indicators of PSA, ADC, and Relative T2 Value.Diagnostics (Basel, Switzerland) · 2026Article
- Impact of central review and MRI image quality on prostate cancer diagnosis and biopsy decision-making in referred patients.Abdominal radiology (New York) · 2026Article
- Comprehensive biochemical insights into derivatives of PSA and glycosylation-specific changes in PSA: role in diagnosis and management of prostate cancer.Clinical proteomics · 2026Review
- Burden and Trends of Genitourinary Cancers Across the Americas: A GBD 2023 Analysis of Regional Socioeconomic Gradients.Cancers · 2026Article
- Diagnosis of Prostate Cancer: A Comparative Evaluation of Biological Techniques.Diseases (Basel, Switzerland) · 2026Review
- APOE ε2/ε3 is associated with multi-layered protection against prostate cancer in Chinese men.World journal of urology · 2026Article
- Integrating Multiparametric MRI and PSMA PET Imaging in Prostate Cancer: Toward a Unified Diagnostic and Risk-Stratification Paradigm.Medicina (Kaunas, Lithuania) · 2026Review
- Urine-based PSMA detection for noninvasive prostate cancer diagnosis: recent advances, translational challenges, and future perspectives.Frontiers in oncology · 2026Review
- Development and validation of a risk prediction model for prostate cancer integrating quantitative MRI and clinical data.Frontiers in oncology · 2026Article
- Development and validation of a deep learning-based model for predicting prostate cancer in patients with gray-zone PSA levels: a comparative study with clinician observations.World journal of urology · 2025Article
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11 authors.
Funding
Abstract
objectiveTo investigate the diagnostic performance of MRI in detecting clinically significant prostate cancer (csPCa) and prostate cancer (PCa) in patients with prostate-specific antigen (PSA) levels of 4-10 ng/mL.
methodsA computerized search of PubMed, Embase, Cochrane Library, Medline, and Web of Science was conducted from inception until October 31, 2023. We included articles on the use of MRI to detect csPCa or PCa at 4-10 ng/mL PSA. The primary and secondary outcomes were MRI performance in csPCa and PCa detection, respectively; the estimates of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were pooled in a bivariate random-effects model.
resultsAmong the 19 studies (3879 patients), there were 10 (2205 patients) and 13 studies (2965 patients) that reported MRI for detecting csPCa or PCa, respectively. The pooled sensitivity and specificity for csPCa detection were 0.84 (95% confidence interval [CI], 0.79-0.88) and 0.76 (95%CI, 0.65-0.84), respectively, for PCa detection were 0.82 (95%CI, 0.75-0.87) and 0.74 (95%CI, 0.65-0.82), respectively. The pooled NPV for csPCa detection was 0.91 (0.87-0.93). Biparametric magnetic resonance imaging also showed a significantly higher sensitivity and specificity relative to multiparametric magnetic resonance imaging (both p < 0.01).
conclusionProstate MRI enables the detection of csPCa and PCa with satisfactory performance in the PSA gray zone. The excellent NPV for csPCa detection indicates the possibility of biopsy decision-making in patients in the PSA gray zone, but substantial heterogeneity among the included studies should be taken into account. CLINICAL RELEVANCE STATEMENT: Prostate MRI can be considered a reliable and satisfactory tool for detecting csPCa and PCa in patients with PSA in the "gray zone", allowing for reducing unnecessary biopsy and optimizing the overall examination process. KEY POINTS: Prostate-specific antigen (PSA) is a common screening tool for prostate cancer but risks overdiagnosis. MRI demonstrated excellent negative predictive value for prostate cancer in the PSA gray zone. MRI can influence decision-making for these patients, and biparametric MRI should be further evaluated.
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