Comparative Assessment of Different Ultrasound Technologies in the Detection of Prostate Cancer: A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: Prostate cancer (PCa) is considered as one of main causes of death in men globally. More research is required on the diagnostic accuracy of mpUS and advanced modalities in prostate cancer detection, which may provide insightful information into the diagnostic accuracy and clinical utility of this technique. Therefore, we have conducted a systematic review and meta-analysis to assess the diagnostic test accuracy of different ultrasound scanning technologies (shear-wave elastography, contrast enhanced, micro-ultrasound) and grayscale ultrasound technology in the detection of prostate cancer. This will assist in determining whether this new method of detecting prostate cancer is effective. Our results showed that some studies proved that advanced ultrasound modalities are promising methods for the detection of prostate cancer. ABSTRACT: The present study aimed to assess the diagnostic test accuracy of different ultrasound scanning technologies in the detection of prostate cancer. A systematic search was conducted using the Cochrane Guidelines for Screening and Diagnostic Tests. We performed a systematic search in the international databases PubMed, Medline, Ovid, Embase and Cochrane Library. Searches were designed to find all studies that evaluated Micro-US, mpUS, SWE and CEUS as the main detection modalities for prostate cancer. This study was registered with Research Registry of systematic review and meta-analysis. The QUADAS-2 tool was utilized to perform quality assessment and bias analysis. The literature search generated 1376 studies. Of these, 320 studies were screened for eligibility, with 1056 studies being excluded. Overall, 26 studies with a total of 6370 patients met the inclusion criteria. The pooled sensitivity for grayscale, CEUS, SWE, Micro-US and mpUS modalities were 0.66 (95% CI 0.54–0.73) 0.73 (95% CI 0.58–0.88), 0.82 (95% CI 0.75–0.90), 0.85 (95% CI 0.76–0.94) and 0.87 (95% CI 0.71–1.03), respectively. Moreover, the pooled specificity for grayscale, CEUS, SWE, Micro-US and mpUS modalities were 0.56 (95% CI 0.21–0.90), 0.78 (95% CI 0.67–0.88), 0.76 (95% CI 0.65–0.88), 0.43 (95% CI 0.28–0.59) and 0.68 (95% CI 0.54–0.81), respectively. In terms of sensitivity, substantial heterogeneity between studies was detected (I(2) = 72%, p = 0.000 < 0.05). In relation to specificity, extreme heterogeneity was detected (I(2) = 93%, p = 0.000 < 0.05). Some studies proved that advanced ultrasound modalities such as mpUS, Micro-US, shear-wave elastography, contrast enhanced and micro-ultrasound are promising methods for the detection of prostate cancer.