Biparametric magnetic resonance imaging (bpMRI) may be just as effective as multiparametric MRI (mpMRI) in ruling out clinically significant prostate cancer (csPCa), according to a new meta-analysis.
For the meta-analysis, recently published in the American Journal of Roentgenology, researchers reviewed data from 18 studies (a total of 4,653 patients) to compare the negative predictive value (NPV) of mpMRI and bpMRI for csPCa. The meta-analysis authors noted that 15 of the reviewed studies involved simulated bpMRI exams (removing dynamic contrast-enhanced images from mpMRI exams) and three studies had separate bpMRI and mpMRI arms.
Biparametric MRI and mpMRI had equivalent pooled NPV rates of 92 percent for csPCa, according to the meta-analysis authors.
“This systematic review and meta-analysis of 18 studies … found no evidence of a significant difference between the two tests in the NPV for clinically significant prostate cancer, with NPV showing similar ranges across the included studies for each test,” wrote lead study author Emmanuel Salinas-Miranda, M.D., who is affiliated with the Department of Radiology at the Ottawa Hospital in Ottawa, Canada, and colleagues.
For the 12 studies involving only 3T MRI exams, the meta-analysis authors noted equivalent NPV rates (93 percent) for bpMRI and mpMRI. The researchers also noted comparable NPV rates in the three studies focused on 1.5T MRI exams (89 percent for mpMRI vs. 87 percent for bpMRI).
Three Key Takeaways
1. Comparable diagnostic performance. The meta-analysis found that bpMRI and mpMRI had equivalent negative predictive values (NPV) of 92 percent for ruling out csPCa, suggesting that bpMRI may be just as effective as mpMRI in clinical settings.
2. Consistency across MRI strengths and patient groups. Both imaging modalities showed similar NPVs across different MRI strengths (3T and 1.5T) and patient populations (biopsy-naïve and previously biopsied), reinforcing the reliability of bpMRI as an alternative to mpMRI.
3. Potential clinical and economic benefits. Since bpMRI does not require dynamic contrast-enhanced imaging, it could reduce scan times, lower costs, and minimize contrast-related risks, making it a promising alternative for prostate cancer assessment.
The use of mpMRI had a 92 percent NPV for csPCa in 12 studies involving biopsy-naïve patients vs. 91 percent for bpMRI, The meta-analysis authors pointed out equivalent NPV rates (94 percent) for mpMRI and bpMRI in patients with previous biopsies based on three of the reviewed studies.
“These results provide further support for the use of bpMRI as an alternative to mpMRI in clinical practice, complementing prior literature showing comparable PPV between the two tests,” wrote Salinas-Miranda and colleagues.
(Editor’s note: For related content, see “Can Deep Learning Ultra-Fast bpMRI Have an Impact in Prostate Cancer Imaging?,” “Emerging AI Software for Prostate MRI Offers 95 Percent Sensitivity for csPCa” and “Emerging Concepts and Recommendations for MRI in Prostate Cancer Screening.”)
In regard to limitations of the meta-analysis, the authors acknowledged that the NPV for simulated bpMRI exams was drawn from biopsy or radical prostatectomy procedures following the use of mpMRI to help make those intervention decisions. Only three of the reviewed studies had longitudinal follow-up, according to the researchers. They added that the study did not assess the impact of bpMRI on scan times and health-care costs.
