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 (I2= 72%,p= 0.000 < 0.05). In relation to specificity, extreme heterogeneity was detected (I2= 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.
本研究旨在评估不同超声扫描技术在前列腺癌检测中的诊断准确性。根据Cochrane筛查与诊断测试指南，我们在国际数据库PubMed、Medline、Ovid、Embase及Cochrane图书馆中进行了系统性检索。检索策略旨在纳入所有以前列腺癌为主要检测目标、评估微超声、多参数超声、剪切波弹性成像及超声造影技术的研究。本系统综述与荟萃分析已在研究注册平台完成注册。采用QUADAS-2工具进行质量评估与偏倚分析。文献检索共获得1376项研究，经筛选后排除1056项，最终对320项研究进行资格评估。共有26项研究（总计6370例患者）符合纳入标准。灰阶超声、超声造影、剪切波弹性成像、微超声及多参数超声的汇总敏感度分别为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）和0.87（95% CI 0.71–1.03）；汇总特异度分别为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）和0.68（95% CI 0.54–0.81）。敏感度分析显示研究间存在显著异质性（I²=72%，p=0.000<0.05），特异度分析呈现极高异质性（I²=93%，p=0.000<0.05）。部分研究证实，多参数超声、微超声、剪切波弹性成像及超声造影等先进超声技术是前列腺癌检测的有效方法。
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