Unveiling the diagnostic potential of diffusion kurtosis imaging and intravoxel incoherent motion for detecting and characterizing prostate cancer: a meta-analysis.

ABSTRACT

PURPOSE: This study aims to assess the diagnostic capabilities of Diffusion Kurtosis Imaging (DKI) and Intravoxel Incoherent Motion (IVIM) in prostate cancer (PCa) detection and characterization. MATERIALS A comprehensive search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for articles published up to September 10, 2023, that evaluated the diagnostic efficacy of MD, MK, Dt, f, and Dp parameters. Data were pooled using a bivariate mixed-effects regression model and analyzed with R software. RESULTS: In total, 27 studies were included. The analysis revealed distinct diagnostic efficacies for DKI and IVIM. In the overall model, sensitivity and specificity were 0.807 and 0.797, respectively, with prospective studies showing higher specificity (0.858, p = 0.024). The detection model yielded increased sensitivity (0.845) and specificity (0.812), with DKI outperforming IVIM in both metrics (sensitivity 0.87, p = 0.043; specificity 0.837, p = 0.26); MD had high sensitivity (0.88) and specificity (0.82), while MK's specificity was significantly higher (0.854, p = 0.04); Dp's sensitivity was significantly lower (0.64, p = 0.016). In characterization, sensitivity and specificity were 0.708 and 0.735, respectively, with no significant differences between DKI and IVIM or Gleason Scores; MK had higher sensitivity (0.78, p = 0.039), and f's sensitivity was significantly lower (0.51, p = 0.019). CONCLUSION: In summary, the study underscores DKI's enhanced diagnostic accuracy over IVIM in detecting PCa, with MK standing out for its precision. Conversely, Dp and f lag in diagnostic performance. Despite these promising results, the study highlights the imperative for standardized protocols and study designs to achieve reliable and consistent outcomes.