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

Abstract Background and objectives 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. Material and methods 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 Ktrans and Kep and Ve values with standard deviation. In total, 13 studies with overall 894 patients were suitable for the analysis and included into the present study. Results The highest correlation was identified for Ktrans 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 Ktrans 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). Conclusion DCE-MRI cannot be used to predict GS in PC, and consequently cannot discriminate clinically significant from non-significant cancers.