Multiparametric magnetic resonance imaging (mpMRI) has improved the triage of men with suspected prostate cancer, through precision prebiopsy identification of clinically significant disease. While multiple important characteristics, including tumour grade and size have been shown to affect conspicuity on mpMRI, tumour location and association with mpMRI visibility is an underexplored facet of this field. Therefore, the objective of this systematic review and meta-analysis is to collate the extant evidence comparing MRI performance between different locations within the prostate in men with existing or suspected prostate cancer. This review will help clarify mechanisms that underpin whether a tumour is visible, and the prognostic implications of our findings.
The databases MEDLINE, PubMed, Embase and Cochrane will be systematically searched for relevant studies. Eligible studies will be full-text English-language articles that examine the effect of zonal location on mpMRI conspicuity. Two reviewers will perform study selection, data extraction and quality assessment. A third reviewer will be involved if consensus is not achieved. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will inform the methodology and reporting of the review. Study bias will be assessed using a modified Newcastle-Ottawa scale. A thematic approach will be used to synthesise key location-based factors associated with mpMRI conspicuity. A meta-analysis will be conducted to form a pooled value of the sensitivity and specificity of mpMRI at different tumour locations.
Ethical approval is not required as it is a protocol for a systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations.
BMJ open. 2022 Jan 05*** epublish ***
Pranav Satish, Alex Freeman, Daniel Kelly, Alex Kirkham, Clement Orczyk, Benjamin S Simpson, Francesco Giganti, Hayley C Whitaker, Mark Emberton, Joseph M Norris
UCL Division of Surgery & Interventional Science, UCL Medical School, London, UK., Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK., School of Healthcare Sciences, Cardiff University, Cardiff, UK., Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK., Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK., UCL Cancer Institute, University College London, London, UK., Division of Surgery and Interventional Science, University College London, London, UK., Division of Surgery and Interventional Science, University College London, London, UK .