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@ARTICLE{Carletti:300739,
      author       = {F. Carletti and M. Maggi and T. Fazekas and P. Rajwa and R.
                      Nicoletti and J. Olivier and F. Preisser and T. F. W.
                      Soeterik and F. Giganti and A. Martini and I. Heidegger and
                      V. Kasivisvanathan and B. Pradère and G. Ploussard and B.
                      Hadaschik$^*$ and F. D. Moro and R. C. N. van den Bergh and
                      G. Marra and G. Gandaglia and F. Zattoni and C. Kesch$^*$},
      collaboration = {E. P. C. W. Party},
      title        = {{D}iagnostic accuracy of multiparametric {MRI} for
                      detecting unconventional prostate cancer histology: a
                      systematic review and meta-analysis.},
      journal      = {European radiology},
      volume       = {36},
      number       = {1},
      issn         = {0938-7994},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-00899},
      pages        = {17-29},
      year         = {2026},
      note         = {2026 Jan;36(1):17-29 / Epub 2025 Apr 30},
      abstract     = {Accurate detection of unconventional histologies (UH) in
                      prostate cancer (PCa) is crucial for treatment planning and
                      prognosis. This systematic review and meta-analysis aimed to
                      evaluate the accuracy of multiparametric magnetic resonance
                      imaging (mpMRI) in detecting UH on prostatectomy,
                      particularly cribriform architecture (CA) and intraductal
                      carcinoma (IDC-P), in patients with localized PCa.A
                      literature search was conducted in major databases for
                      studies published after 2000. Seventeen articles fulfilled
                      the inclusion criteria and were eligible for qualitative
                      analysis. Five studies met the inclusion criteria for
                      meta-analysis.The pooled sensitivity and specificity of
                      mpMRI (Prostate Imaging Reporting and Data System (PI-RADS)
                      cutoff 3) to detect cribriform architecture were 0.91 and
                      0.29. The proportion of cribriform lesions increased with
                      higher PI-RADS scores $(23.2\%$ for PI-RADS 1-2 to $66.7\%$
                      for PI-RADS 5). For intraductal carcinoma (IDC-P), two
                      studies found that IDC-P lesions were visible on mpMRI and
                      had lower apparent diffusion coefficient (ADC) values
                      compared to acinar prostate cancer. Four studies evaluating
                      combined CA/IDC-P found sensitivities ranging from 33 to
                      $100\%.$ Lower ADC values were associated with CA/IDC-P in
                      some studies, but not in others. Overall, mpMRI demonstrated
                      promising sensitivity but moderate specificity in detecting
                      these aggressive histological variants, with continued
                      challenges in accurate sampling and characterization of
                      mpMRI.mpMRI shows high sensitivity but moderate specificity
                      in detecting cribriform architecture in PCa, especially for
                      high PI-RADS scores. These findings support the use of mpMRI
                      for UH detection, but caution is advised in clinical
                      interpretation. Larger prospective studies are needed to
                      validate these results before routine clinical application.
                      We studied how effective MRI is at identifying different UH
                      of PCa, such as cribriform architecture and intraductal
                      carcinoma. MRI is accurate at detecting these cancers when
                      they are present, but it also produces a significant number
                      of false positives. More research is needed to standardize
                      imaging protocols and histological definition and ensure an
                      accurate diagnosis.Question The accurate detection of
                      unconventional histologies in prostate cancer, particularly
                      cribriform architecture and intraductal carcinoma, is
                      challenging but crucial for treatment planning and
                      prognosis. Findings mpMRI shows high sensitivity $(91\%)$
                      but low specificity $(29\%)$ for detecting cribriform
                      architecture, with detection rates increasing proportionally
                      with higher PI-RADS scores. Clinical relevance mpMRI can
                      effectively detect aggressive unconventional histologies in
                      prostate cancer, though its moderate specificity suggests
                      the need for careful interpretation. This aids in risk
                      stratification and treatment planning, potentially improving
                      patient outcomes.},
      subtyp        = {Review Article},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40307530},
      doi          = {10.1007/s00330-025-11603-3},
      url          = {https://inrepo02.dkfz.de/record/300739},
}