Diagnostic Accuracy of Multi-Parametric Magnetic Resonance Imaging for Tumor Staging of Bladder Cancer: Meta-Analysis

Purpose：Evaluate the diagnostic accuracy of multi-parametric magnetic resonance imaging (mp-MRI) for local staging of bladder cancer (BCa). Materials and Methods： The databases of PubMed, Web of Science, Wanfang, and CNKI were searched for related literatures about BCa diagnosed by mp-MRI from January 1, 2000 to April 12, 2019. The strict inclusion and exclusion criteria were set up to extract records. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was used to evaluate quality of the candidate studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR) were calculated to assess the diagnostic authenticity of mp-MRI. The summarized receiver operating characteristic (SROC) curve corresponding with the area under the curve (AUC) were analyzed to comprehensively evacuate the diagnostic value of mp-MRI. Results： A total of 140 studies were retrieved by computer-based searching. After quality control, 4 studies with 259 patients were enrolled for meta-analysis. The pooled results showed 0.84 of sensitivity [95% confidence interval (CI) =0.79-0.89], 0.91 of specificity (95% CI=0.87-0.93), 8.24 of +LR (95% CI=4.87-13.92), 0.18 of –LR (95% CI=0.10-0.31), 49.42 of DOR (95% CI=19.07-128.09), and 0.946 of AUC. The Spearman correlation analysis found no threshold effect (p=0.684). A significant heterogeneity existed among 4 included studies with sensitivity (I² = 65.7%), specificity (I² = 60.0%) and diagnostic OR (I²=67.5%). The Begg’s test (p=0.497) and the egger’s test (p=0.337) found no publication bias. Conclusion： mp-MRI acts a good diagnostic performance for bladder cancer. It is plausible that mpMRIs can be used as an important method for bladder cancer staging.