Can dynamic contrast enhanced MRI predict gleason score in prostate cancer? a systematic review and meta analysis

Multiparametric MRI has become a corner stone in diagnosis of prostate cancer (PC). DCE-MRI is used to quantify the influx of contrast media into tissues, which was shown to correlate with histopathology features. The present analysis sought to correlate DCE-MRI parameters with Gleason score (GS) based upon a large patient sample.

MEDLINE library, Cochrane and SCOPUS databases were screened for the associations between DCE-MRI and GS in PC up to April 2020. The primary endpoint of the systematic review was the correlation between DCE-MRI parameters and GS and mean K^trans and K_ep and V_e values with standard deviation. In total, 13 studies with overall 894 patients were suitable for the analysis and included into the present study.

The highest correlation was identified for K^trans with a pooled correlation coefficient of r = 0.36 (95% CI 0.14-0.59). A large overlap was identified between clinical significant and non-significant PC for all DCE-parameters, for K^trans the pooled mean value of clinically non-significant PC was 0.32 min^-1 [95% CI 0.13-0.51] and for clinically significant PC it was 0.45 min^-1 (95% CI 0.25-0.64).

DCE-MRI cannot be used to predict GS in PC, and consequently cannot discriminate clinically significant from non-significant cancers.