Precisión diagnóstica de la resonancia magnética multiparamétrica en cáncer de próstata: revisión sistemática y metaanálisis bivariado de 4954 pacientes
DOI:
https://doi.org/10.48193/s7g2sh54Palabras clave:
Resonancia magnética, RM Multiparamétrica, Cáncer de Próstata, Metaanálisis, Diagnóstico, neoplasia prostáticaResumen
Introducción: la resonancia magnética multiparamétrica (RM-Mp) ha demostrado ser crucial para detectar cáncer de próstata clínicamente significativo (CaPCs), una enfermedad que sigue siendo una de las principales causas de morbilidad y mortalidad en hombres. Estudios como PROMIS y PRECISION muestran que, combinada con biopsia dirigida, la RM-Mp supera a la biopsia transrectal sistematizada de 10 a 12 muestras en precisión diagnóstica.
Objetivo: evaluar la eficacia diagnóstica de la RM-Mp en un contexto actualizado.
Diseño y metodología: este estudio es un subanálisis del protocolo registrado en PROSPERO (CRD42024552125). Se realizó una revisión sistemática utilizando PubMed, CENTRAL Cochrane y ClinicalTrials.gov, incluyendo artículos publicados entre 2012 y 2024. Se seleccionaron estudios que compararan la RM-Mp con la resonancia magnética biparamétrica. Se evaluó el riesgo de sesgo con la herramienta QUADAS-2. La sensibilidad, especificidad y el área bajo la curva (AUC) se analizaron mediante un modelo de bivariado; otros indicadores de eficiencia diagnóstica se obtuvieron mediante un modelo univariado.
Resultados: se incluyeron 19 estudios con 4954 pacientes. La sensibilidad global fue del 90.7 %, la especificidad del 64.4 % y el AUC de 0.898, confirmando su alta precisión diagnóstica.
Limitaciones: la principal limitación fue tratarse de un subanálisis sujeto a los lineamientos del protocolo original.
Originalidad y valor: es un metaanálisis actualizado, con metodología robusta y gran tamaño muestral, que refuerza la evidencia actual.
Conclusiones: los resultados demuestran que la RM-Mp, incluso en un contexto actualizado y con un tamaño muestral amplio, mantiene su alta sensibilidad, lo que la convierte en una herramienta esencial para el diagnóstico temprano del CaPCs.
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