前列腺癌仍然是男性中最常诊断出的癌症。高强度聚焦超声 (HIFU) 已成为部分腺体消融 (PGA) 的热消融技术，旨在最大限度地减少附带损伤，同时最大限度地控制肿瘤。 HIFU PGA 后的监测依赖于系列 PSA 测试、多参数 MRI 和活检。 MRI 对临床上显着的癌症 (csPCa) 复发的诊断准确性具有挑战性。本次系统评价和荟萃分析旨在评估 MRI 在检测 HIFU PGA 后局限性前列腺癌早期复发方面的准确性。遵循 PRISMA 指南，全面的使用 MEDLINE 和 Scopus 进行文献检索直至 2024 年 5 月 8 日。纳入标准包括随机对照试验和队列研究，涉及被诊断患有局限性前列腺癌且主要接受 HIFU PGA 治疗的男性。主要结局指标包括基于活检结果的 csPCa (ISUP ≥ 2) MRI 的敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV)。我们汇集了 HIFU 后足够的 csPCa 和无 csPCa 患者 (≥5) 的研究数据进行统计分析。 15 项研究符合纳入标准，涵盖 1093 名患者，其中 12 项研究符合荟萃分析条件。 MRI 检测 HIFU PGA 后有临床意义的前列腺癌 (csPCa) 复发的灵敏度差异很大 (0-89%)，汇总灵敏度为 0.52 (95% CI:0.36-0.68)。特异性范围为 44% 至 100%，合并特异性为 0.81 (95% CI:0.68-0.91)。汇总 NPV 为 0.82（95% CI：0.72-0.90），汇总 PPV 为 0.50（95% CI：0.35-0.65）。三项研究报告了现场诊断性能，灵敏度范围为 0.42 至 0.80，特异性范围为 0.45 至 0.97。使用 HIFU 部分腺体消融治疗局限性前列腺癌后，MRI 对有临床意义的复发的准确性显示，在治疗的肺叶中，综合灵敏度的诊断性能较低为 0.52 (95% CI:0.36-0.68)，特异性为 0.81 (95% CI:0.68-0.91)。本次审查的局限性包括报告治疗肺叶内外复发部位的研究数量较少。© 2024。作者，获得 Springer Nature Limited 的独家许可。

Prostate cancer remains the most frequently diagnosed cancer among men. High-Intensity Focused Ultrasound (HIFU) has emerged as a thermal ablative technique for partial-gland-ablation (PGA), aiming to minimize collateral damage while maximizing tumor control. Monitoring after HIFU PGA relies on serial PSA testing, multiparametric-MRI, and biopsies. The diagnostic accuracy of MRI for clinically-significant cancer(csPCa) recurrence is challenging.This systematic review and meta-analysis aim to evaluate the accuracy of MRI in detecting early recurrence of localized prostate cancer following HIFU PGA.Adhering to PRISMA guidelines, a comprehensive literature search was conducted until May 8th 2024 using MEDLINE and Scopus. The inclusion criteria encompassed randomized controlled trials and cohort studies involving men diagnosed with localized prostate cancer who had as primary treatment HIFU PGA. The primary outcome measures included the sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) of MRI for csPCa(ISUP ≥ 2) based on biopsy results. We pooled data from studies with sufficient csPCa and csPCa-free patients (≥5) post HIFU for statistical analysis.Fifteen studies meet the inclusion criteria, encompassing 1093 patients and 12 studies were eligible for meta-analysis. MRI sensitivity in detecting clinically-significant prostate cancer (csPCa) recurrence post HIFU PGA varied widely (0-89%), with a pooled sensitivity of 0.52 (95% CI:0.36-0.68). Specificity ranged from 44% to 100%, with a pooled specificity of 0.81 (95% CI:0.68-0.91). The pooled NPV was 0.82 (95% CI:0.72-0.90), and the pooled PPV was 0.50 (95% CI:0.35-0.65). Three studies reported in-field diagnostic performance with sensitivities ranging from 0.42 to 0.80 and specificities from 0.45 to 0.97.MRI accuracy for clinically-significant recurrence after partial gland ablation with HIFU for localized prostate cancer shows low diagnostic performance in the treated lobe with pooled sensitivity of 0.52 (95% CI:0.36-0.68) and specificity of 0.81 (95% CI:0.68-0.91). Limits of this review include the low number of studies reporting about site of recurrence in or out of the treated lobe.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.