Evidence map›Paper›PMID 41171406›Full record

SynthesisAbdominal radiology (New York)2026

Standalone 29-MHz micro-ultrasound for classifying clinically significant prostate cancer: a systematic review and diagnostic test accuracy meta-analysis of prospective studies.

Ahmed M Abdel Gawad, Ahmed Y Aboelsaad, Ahmed Fawzi Elsayed, Elsayed Mohamed Abd El-Hamid Hassan, Ahmed Yahia Ashour, Alshimaa Yahia Ashour, Eman M El-Dydamony, Maha M Elzamek, Amany Ahmed Soliman, Hany Elsegeay and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

15 authors.

Ahmed M Abdel GawadUrology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ahmed Y AboelsaadUrology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ahmed Fawzi ElsayedUrology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Elsayed Mohamed Abd El-Hamid HassanRadiology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Ahmed Yahia AshourRadiology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Alshimaa Yahia AshourRadiology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Eman M El-DydamonyUrology department, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt.
Maha M ElzamekUrology department, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt.
Amany Ahmed SolimanUrology department, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt.
Hany ElsegeayUrology Department, Faculty of Medicine, Al- Azhar university, Asyut, Egypt.
Ahmed Farag WahshUrology Department, Faculty of Medicine, Al- Azhar university, Asyut, Egypt.
Mohamed Fathy ElebiaryUrology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed Abd El Rahman AlkenawyRadiology Department, Faculty of Medicine, Al-Azhar University,, Cairo, Egypt.
Mohamed Hamouda ElkasabyFaulty of Medicine, Al-Azhar University, Cairo, Egypt.
Atef A HassanFaulty of Medicine, Al-Azhar University, Cairo, Egypt. atefabdo26399@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMicro-ultrasound (micro-US; 29-MHz) offers real-time, high-resolution prostate imaging, but its stand-alone diagnostic accuracy remains uncertain. We synthesized prospective evidence to evaluate micro-US for classifying clinically significant prostate cancer (csPCa) using histopathology as the reference standard.

methodsWe searched PubMed, Embase, Scopus, and Web of Science (inception-20 May 2025) for prospective studies assessing micro-US as an index test on a diagnostic pathway. Data were pooled using random-effects models on logit-transformed sensitivity and specificity, with an HSROC representation and model diagnostics. Subgroup and meta-regression analyses explored heterogeneity, including threshold (PRI-MUS) and spectrum effects. Clinical utility was appraised using Fagan nomograms and a likelihood-ratio scatter. Small-study effects were evaluated with Deeks' test.

resultsFive prospective studies met criteria. Pooled sensitivity was 0.84 (95% CI 0.65-0.94) and pooled specificity was 0.41 (95% CI 0.25-0.59), indicating moderate discrimination on HSROC. Secondary metrics were concordant (PLR 1.45, 95% CI 1.17-1.80; NLR 0.37, 95% CI 0.23-0.61; DOR 3.95, 95% CI 2.48-6.30). On a 25% pre-test probability, the Fagan nomogram showed modest shifts (~ 33% after a positive test; ~11% after a negative), supporting a triage/rule-out role. Heterogeneity was substantial and strongly influenced by threshold and clinical spectrum differences; subgroup and meta-regression suggested that spectrum-related factors were associated with lower specificity, whereas no covariate robustly altered sensitivity (exploratory given small k). Model checks were acceptable, and Deeks' test showed no evidence of small-study effects (p ≈ 0.70).

conclusionAs a stand-alone index test for csPCa classification, micro-US demonstrates high sensitivity but low specificity, yielding modest impact on post-test probability. These findings support micro-US as a complementary/triage (rule-out) adjunct, particularly when mpMRI is unavailable, contraindicated, or delayed, while highlighting the need for standardized PRI-MUS thresholds, reader training, and larger multicenter studies to refine specificity and clarify integration with MRI-based pathways.

Indexed as

Prostatic NeoplasmsHumansMaleProspective StudiesSensitivity and SpecificityUltrasonographyClinically significant prostate cancerDiagnostic test accuracyFagan nomogramHSROCLikelihood ratiosMicro-ultrasoundPRI-MUS

Identifiers

PMID41171406
PMCPMC13109128

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.