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AJR Am J Roentgenol. 2012 Oct;199(4):822-9.

Diffusion-weighted MRI in the detection of prostate cancer: meta-analysis.

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Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.



The objective of our study was to estimate and compare the performance of diffusion-weighted imaging (DWI) with other MRI techniques including T2-weighted MRI for the detection of prostate cancer.


Searches of the PubMed and Scopus electronic databases for the terms "prostate," "cancer," "diffusion-weighted imaging," and "magnetic resonance imaging" using an end date of December 2010 were completed. All included studies had histopathologic correlation; 2×2 contingency data were constructed for each study. A Bayesian receiver operating characteristic (ROC) model was used across studies to determine sensitivity, specificity, and area under the full or partial ROC curve.


Nineteen articles consisting of a total of 5892 lesions were analyzed. Based on a 95% credible interval, DWI alone yielded a significantly better area under the ROC curve, sensitivity, and specificity (0.85, 0.69, 0.89, respectively) than T2-weighted imaging alone (0.75, 0.60, 0.76). Combined DWI and T2-weighted imaging (0.73, 0.70, 0.83) showed a similar area under the ROC curve but significantly better sensitivity and specificity than T2-weighted imaging alone. DWI and combined DWI and T2-weighted imaging yielded similar overall sensitivity, but DWI alone showed better overall specificity than combined DWI and T2-weighted imaging. At specificities of greater than 80%, combined DWI and T2-weighted imaging yielded a partial area under the ROC curve (0.138) similar to that of DWI alone (0.129) and was significantly better than the partial area under the ROC curve of T2-weighted imaging alone (0.070). DWI alone and combined DWI and T2-weighted imaging appear to be superior to dynamic contrast-enhanced imaging alone (area under the ROC curve, 0.79; sensitivity, 0.58; specificity, 0.82).


DWI appears to improve diagnostic performance and can be a useful adjunct to conventional anatomic imaging for identifying tumor foci in prostate cancer.

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