A Prospective Accuracy Study of Prostate Imaging Reporting and Data System Version 2 on Multiparametric Magnetic Resonance Imaging in Detecting Clinically Significant Prostate Cancer With Whole-mount Pathology

Urology ◽  
2019 ◽  
Vol 123 ◽  
pp. 191-197 ◽  
Author(s):  
Gianluca Giannarini ◽  
Rossano Girometti ◽  
Alessandro Crestani ◽  
Marta Rossanese ◽  
Mattia Calandriello ◽  
...  
2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  

Abstract Background The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP. Methods A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥ 3 + 4 (GS ≥ 3 + 4 or diameter > 10 mm) and csCaP/GS ≥ 4 + 3 (GS ≥ 4 + 3 or diameter > 10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥ 3. Results The sensitivity of all legions, csCaP/GS ≥ 3 + 4, csCaP/GS ≥ 4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥ 3 + 4. There were three lesions with a GS of ≥ 8 and ≥ 10 mm in the false-negative results. Conclusions mpMRI can highly detect ITs and csCaP/GS ≥ 4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.


2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  

Abstract Background: The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP.Methods: A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥3 + 4 (GS ≥3 + 4 or diameter >10 mm) and csCaP/GS ≥4 + 3 (GS ≥4 + 3 or diameter >10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥3.Results: The sensitivity of all legions, csCaP/GS ≥3 + 4, csCaP/GS ≥4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥3 + 4. There were three lesions with a GS of ≥8 and ≥10 mm in the false-negative results.Conclusions: mpMRI can highly detect ITs and csCaP/GS ≥4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.


2021 ◽  
Vol 28 (2) ◽  
pp. 1294-1301
Author(s):  
Daiki Kato ◽  
Kaori Ozawa ◽  
Shinichi Takeuchi ◽  
Makoto Kawase ◽  
Kota Kawase ◽  
...  

This study aimed to determine the predictive value of the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) based on biparametric magnetic resonance imaging (bpMRI) with combined target biopsy (TBx) and systematic biopsy (SBx) in patients with suspicion of having clinically significant prostate cancer (csPCa). In this retrospective study, we reviewed the clinical and pathological records of 184 consecutive patients who underwent bpMRI before prostate biopsy. We focused on patients with PI-RADS v2 scores ≥ 3. MRI was performed using a 3-Tesla clinical scanner with a 32-channel phased-array receiver coil. PI-RADS v2 was used to describe bpMRI findings based on T2-weighted imaging and diffusion-weighted imaging scores. The primary endpoint was the diagnostic accuracy rate of PI-RADS v2 based on bpMRI for patients with prostate cancer (PCa) who underwent combined TBx and SBx. A total of 104 patients were enrolled in this study. Combined TBx and SBx was significantly superior to either method alone for PCa detection in patients with suspicious lesions according to PI-RADS v2. TBx and SBx detected concordant csPCa in only 24.1% of the patients. In addition, the rate of increase in the Gleason score was similar between SBx (41.5%) and TBx (34.1%). The diagnostic accuracy of bpMRI is comparable to that of standard multiparametric MRI for the detection of csPCa. Moreover, combined TBx and SBx may be optimal for the accurate determination of csPCa diagnosis, the International Society of Urological Pathology grade, and risk classification.


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