Diagnostic accuracy of magnetic resonance imaging for tumour staging of bladder cancer: systematic review and meta-analysis

Abstract

The purpose of this study is to evaluate accuracy of magnetic resonance imaging (MRI) for local staging of bladder cancer for four clinical scenarios (T-stage thresholds) considered against current standards for clinical staging and secondarily to identify sources for variability in accuracy. Systematic review of patients with bladder cancer undergoing T-staging MRI to evaluate the diagnostic accuracy using bivariate random-effects meta-analysis. Sub-group analysis was done to explore variability; risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. The search identified 30 studies (5156 patients). Pooled accuracy at multiple T-stage thresholds: ≤T1 vs ≥T2 = sensitivity 87% (95% confidence interval [CI] 82–91), specificity 79% (95% CI 72–85); T-any vs T0 = sensitivity 65% (95% CI 23–92), specificity 90% (95% CI 83–94); ≤T2 vs ≥T3 = sensitivity 83% (95% CI 75–88), specificity 87% (95% CI 78–93); and