MP16-06 DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING (MRI) 5-POINT LIKERT SCORING SYSTEM EVALUATED BY THE RESULT OF MRI/ULTRASONOGRAPHY FUSION TARGETED BIOPSY OF THE PROSTATE

Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.

Download Full-text

MRI-TRUS fusion biopsy in diagnostics of prostate cancer

Experimental and Сlinical Urology ◽

10.29188/2222-8543-2021-14-3-86-93 ◽

2021 ◽

Vol 14 (3) ◽

pp. 86-93

Author(s):

R.A. Romanov ◽

◽

A.V. Koryakin ◽

A.V. Sivkov ◽

B.Ya. Alekseev ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Prostate Biopsy ◽

Targeted Biopsy ◽

Resonance Imaging ◽

Fusion Biopsy ◽

Advantages And Disadvantages ◽

Magnetic Resonance Imaging Mri ◽

Targeted Biopsies

Introduction. Significant improvement in the quality of visualization of the prostate using magnetic resonance imaging (MRI), as well as the development of technologies for virtual combination of MRI and ultrasound images opens new horizons in the diagnosis of prostate cancer. The introduction of the PI-RADS system has allowed the standardization of MRI findings, and the development of fusion biopsy systems seeks to make diagnostics more accurate and less operator-dependent. Materials and methods. In this literature review, we evaluate the effectiveness of various biopsy approaches and discuss the prospects for targeted biopsies. The search for publications was carried out in the databases PubMed, e-library, Web of Scince et al. For citation, 55 literature sources were selected that met the search criteria for the keywords, «prostate cancer», «biopsy», «MRI», «TRUS», «fusion». Results. Diagnosis of prostate cancer using MRI. Modern technologies for radiological diagnosis of prostate cancer using magnetic resonance imaging (MRI) are based on the standardized PI-RADS protocol, using different modes (T2, diffusion-weighted images and contrast enhancement), which provides the best visualization of tumor-suspicious nodes in the prostate gland, allowing determination of lesion localization and size for subsequent targeted biopsy. Options for performing a prostate biopsy to diagnose prostate cancer. A description of the methods and effectiveness of transrectal and transperineal biopsy under ultrasound guidance is carried out - due to the fact that ultrasound diagnostics of prostate cancer has a rather low sensitivity due to small differences in the ultrasound structure of normal and tumor tissue of the prostate, an extended template biopsy technique was proposed, which involves puncture of the prostate through a special lattice. It also describes the technology of fusion biopsy and also provides literature data comparing the diagnostic accuracy of standard TRUS and fusion prostate biopsy, as well as the importance of transrectal / transperineal access. Questions for further study. Given the desire to reduce the number of biopsies while maintaining or even increasing the accuracy of diagnosing prostate cancer, data from studies investigating the feasibility of combining polyfocal (non-targeted) and targeted (targeted) biopsies are presented. Conclusion. The existing methods of non-targeted biopsy (polyfocal, saturation, template) and targeted (fusion biopsy) have their advantages and disadvantages, which currently do not allow making certain recommendations for their use, but a significant number of authors prefer MRI-as sisted, fusion -biopsy.

Download Full-text

Corrigendum to “What is the diagnostic accuracy of red flags related to cauda equina syndrome (CES), when compared to Magnetic Resonance Imaging (MRI)? A systematic review” [Musculoskelet. Sci. Pract. 42 (2019) 125–133]

Musculoskeletal Science and Practice ◽

10.1016/j.msksp.2019.07.001 ◽

2019 ◽

Vol 43 ◽

pp. 128

Author(s):

Nathalie Dionne ◽

Abiodun Adefolarin ◽

Dena Kunzelman ◽

Nitin Trehan ◽

Laura Finucane ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Cauda Equina Syndrome ◽

Cauda Equina ◽

Red Flags ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri

Download Full-text

Magnetic Resonance Imaging of the Rheumatic Foot According to the RAMRIS System Is Reliable

The Journal of Rheumatology ◽

10.3899/jrheum.100906 ◽

2011 ◽

Vol 38 (6) ◽

pp. 1003-1008 ◽

Cited By ~ 19

Author(s):

HENRIËTTE BAAN ◽

ROLAND BEZOOIJEN ◽

JOHANNES K.A. AVENARIUS ◽

ROSEMARY DUBBELDAM ◽

WIEPKE K. DROSSAERS-BAKKER ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Scoring System ◽

Bone Erosion ◽

Outcome Measurement ◽

Random Sets ◽

Resonance Imaging ◽

Bone Edema ◽

Magnetic Resonance Imaging Mri

Objective.In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA.Methods.Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion.Results.For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent.Conclusion.Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.

Download Full-text

Prostate cancer detection with magnetic resonance imaging (MRI)/cognitive fusion biopsy: Comparing standard and targeted prostate biopsy with final prostatectomy histology

Canadian Urological Association Journal ◽

10.5489/cuaj.6951 ◽

2021 ◽

Vol 15 (9) ◽

Author(s):

James Ryan ◽

Mark P. Broe ◽

Diarmaid Moran ◽

David Mulvin ◽

Eric Heffernan ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Prostate Biopsy ◽

Targeted Biopsy ◽

Resonance Imaging ◽

Mri Findings ◽

Final Histology ◽

Magnetic Resonance Imaging Mri ◽

Targeted Biopsies

Introduction: The use of multiparametric magnetic resonance imaging (MRI) with targeted biopsies of the prostate improves the diagnosis of clinically significant prostate cancer. Recent studies have shown that targeted prostate biopsies also more accurately predict final histopathology after radical prostatectomy (RP). There are three broad techniques for performing MRI-targeted prostate biopsy: cognitive MRI/ultrasound (US) fusion, software MRI/US fusion, and in-bore MRI-guided. Current practices recommend that a standard systematic 12-core prostate biopsy be performed, as well as targeted biopsies in patients with positive MRI findings. This study aimed to evaluate the accuracy of histological grading of cognitive MRI/US fusion prostate biopsy by comparing the histology from the targeted biopsy specimens (TB), standard systematic specimens (SB), and the combination of both (CB) specimens with the final histological grade from subsequent prostatectomy. Methods: A retrospective, single-center review of 115 patients who underwent standard systematic and cognitive MRI/US-targeted biopsy of the prostate before undergoing a RP between 2016 and 2019 was performed. MRI findings, biopsy, final histology International Society of Urological Pathology (ISUP) grades, and patient demographics were collected. Cochran’s Q test and McNemar test were used to compare the differences in upgrading, downgrading, and concordance between each biopsy group. Results: The concordance between SB, TB, and CB biopsy were 28.7%, 49.6%, and 50.4%, respectively. There was no significant difference in concordance between TB and CB. Patients were more likely to be downgraded on the final histology when comparing CB with TB alone (26.1% vs. 16.5%, p<0.05). In cases where an ISUP grade 1 cancer was diagnosed on TB (n=24), there was a 62.5% chance that the final histology would be upgraded. In the same sample, when combined with a SB, the risk of upgrading on final histology reduced to 37.5%. Conclusions: Although grading concordance between TB and CB were similar, the concomitant use of a SB significantly reduced the rate of upgrading in the final RP histopathology. CB may result in better decision-making regarding treatment options and also have implications for intraoperative planning.

Download Full-text