scholarly journals Usefulness of Grayscale Values of Hypoechoic Lesions Matched with Target Lesions Observed on Magnetic Resonance Imaging for the Prediction of Clinically Significant Prostate Cancer

Author(s):  
Dong Gyun Kim ◽  
Jeong Woo Yoo ◽  
Kyo Chul Koo ◽  
Byung Ha Chung ◽  
Kwang Suk Lee

Abstract Background: To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI) according to the Prostate Imaging-Reporting and Data System (PI-RADS).Methods: We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion-targeted biopsies between January 2017 and September 2020. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values.Results: Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. There was no difference in the median grayscale values between benign and prostate cancer lesions. However, grayscale ranges (41.8–98.5 and 42.6–91.8) were significant predictors of prostate cancer and clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables (age, prostate-specific antigen levels, prostate volume, previous prostate biopsy results, and PI-RADS scores) was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828; p=0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (74.5 vs. 58.8, p=0.008). Grayscale values were the only significant predictive factor (odds ratio=4.46, p=0.005) for csPC.Conclusions: Distribution of grayscale values according to PI-RAD 3 scores was useful, and the grayscale range (42.6–91.8) was an important factor for csPC diagnosis.

2021 ◽  
Author(s):  
Dong Gyun Kim ◽  
Jeong Woo Yoo ◽  
Kyo Chul Koo ◽  
Byung Ha Chung ◽  
Kwang Suk Lee

Abstract INTRODUCTION: To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI). METHODS We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion biopsies. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values. RESULTS Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. Grayscale ranges (42.6–91.8) were significant predictors of clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828; p = 0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (p = 0.008). Grayscale values were the only significant predictive factor (p = 0.005) for csPC. CONCLUSIONS Distribution of grayscale values according to PI-RAD 3 scores was useful, and the grayscale range (42.6–91.8) was an important factor for csPC diagnosis.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Luke L. Wang ◽  
Brandon L. Henslee ◽  
Peter B. Sam ◽  
Chad A. LaGrange ◽  
Shawna L. Boyle

Objective. The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of abnormal digital rectal examination. Methods. 260 patients with suspected localized prostate cancer with no prior biopsy underwent prostate magnetic resonance imaging and were found to have Prostate Imaging Reporting and Data System score ≥   3 lesion(s). All 260 patients underwent standard 12-core biopsy and targeted biopsy during the same session. Clinically significant cancer was Gleason ≥ 3 + 4. Results. Percentages of patients with prostate-specific antigen 0–1.99, 2–3.99, 4–4.99, 5–5.99, 6–9.99, and ≥ 10 were 3.0%, 4.7%, 20.8%, 16.9%, 37.7%, and 16.9%, respectively. Cumulative frequency of clinically significant prostate cancer increased with the addition of targeted biopsy compared with standard biopsy alone across all prostate-specific antigen ranges. The difference in clinically significant cancer detection between targeted plus standard biopsy compared to standard biopsy alone becomes statistically significant at prostate-specific antigen >4.3 ( p = 0.031 ). At this threshold, combination biopsy detected 20 clinically significant prostate cancers, while standard detected 14 with 88% sensitivity and 20% specificity. Excluding targeted biopsy in setting of a positive digital rectal exam would save 12.3% magnetic resonance imaging and miss 1.8% clinically significant cancers in our cohort. Conclusions. In biopsy-naïve patients, at prostate-specific antigen >4.3, there is a significant increase in clinically significant prostate cancer detection when targeted biopsy is added to standard biopsy. Obtaining standard biopsy alone in patients with abnormal digital rectal examinations would miss 1.8% clinically significant cancers in our cohort.


2017 ◽  
Vol 11 (9) ◽  
pp. E330-7 ◽  
Author(s):  
Franck Bladou ◽  
Cora Fogaing ◽  
Mark Levental ◽  
Samuel Aronson ◽  
Mona Alameldin ◽  
...  

Introduction: Magnetic resonance imaging (MRI) is being more widely used in the detection of prostate cancer (PCa), particularly after an initial negative biopsy. In this study, we compared 12-core systematic biopsy (SYS), MRI-targeted biopsy (TAR), and the association of systematic and MRI-targeted (SYS+TAR) prostate biopsy in patients with previous biopsy and those who were biopsy-naive to evaluate the differences in terms of cancer detection and clinically significant cancer detection between the three modalities.Methods: Overall, 203 consecutive patients with suspicion of PCa were analyzed; 48.2% were biopsy-naive and 51.7% had at least one previous negative prostate biopsy. The median age was 66 years, median prostate-specific antigen (PSA) level was 7.9 ng/mL and median prostate volume was 46 mL. 38.9% had SYS, 19.2% TAR only, and 41.8% had SYS+TAR biopsy.Results: Overall, the PCa detection (PCaDR) was 63%. The SYS+TAR biopsy detected significantly more cancer than SYS and TAR only biopsies (72.9% vs. 56.9% and 53.8% respectively; p=0.03). Detection rate of clinically significant cancer (csPCaDR) was 50.7% overall; 65.8% in the SYS+TAR biopsy vs. 39.2% in the SYS and 48.7% in the TAR groups (p=0.002). In the biopsy-naive group, PCaDR and csPCaDR were significantly higher in the SYS+TAR group than in the SYS and TAR groups (p=0.01). In the repeat biopsy group, PCaDR and csPCaDR were equivalent in the TAR and SYS+TAR groups and higher than in the SYS group (p=0.001).Conclusions: TAR biopsy, when added to SYS biopsy, was associated with a higher detection rate of csPCa in biopsy-naive patients when compared to TAR and SYS only biopsies. In patients after previous negative biopsy, detection rates of csPCa were equivalent for SYS+TAR and TAR only biopsies, but higher than SYS.


2021 ◽  
Vol 8 (41) ◽  
pp. 3513-3518
Author(s):  
Sowmya D. ◽  
Anusha S. ◽  
Hari Babu Pidaparti P. ◽  
Jaya Chandra T. ◽  
Mytri Priyadarshini K.

BACKGROUND Prostate is an associated gland of the male reproductive system. Worldwide, among the men, prostate cancer (PC) is the second most common cancer. PC is the seventh commonest cancers among the Indian male. Studies reported that diffusion weighted imaging (DWI) and dynamic contrast enhanced imaging (DCE-MRI), can offer additional value in localizing cancer. A study was conducted to evaluate and correlate the role of DWI in detection and staging of PC and correlation with histopathology. METHODS A cross-sectional observational study was conducted in the Department of Radiodiagnosis, GSL Medical College, over a period of 18 months. Males with symptoms of nocturia, urinary urgency, frequency, hesitancy and bone pain were included in the study. Trans rectal ultrasound scan (TRUS) biopsy was collected, Gleason‘s score (GS) was considered for the histopathologic analysis. The evaluation of DWI as a tool for detection of PC was based on comparing the sensitivity and specificity of the results after taking histopathology as the gold standard test chi-square test was used to find the statistical significance and P < 0.05 was considered statistically significant. RESULTS Total, 36 (82 %) were diagnosed to be malignant, maximum number (18; 50 %) were between 61 – 70 years age group. Peripheral zone is the most common (61.2 %; 22) area for the PC followed by transitional (33.3 %) and central zone (5.5 %). In this study, 16.6 % members had GS ≤6; Apparent diffusion coefficient (ADC) was ranged between 0.81 to 0.87 and mean + SD were 0.85 + 0.02. Out of the 22.2 % members whose GS was 7, the mean + SD ADC were 0.74 ± 0.02. For 22 (61 %) members, GS was >8; the mean + SD ADC was 0.63 ± 0.08; statistically there was significant difference between the parameters. Magnetic resonance imaging (MRI) revealed that 61.3 % (27) cases as highly suspicious, 25 % (11) as probably malignant and 13.6 % (6) as indeterminate; the sensitivity for MRI was 94.5 % and specificity was 85.7 %. CONCLUSIONS Patients with increased prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (MPMRI) is valuable, non-invasive and a better option to detect PC. Also helps in localizing the exact location. KEYWORDS Cancer, Tumour, Biopsy, Study


2021 ◽  
pp. 205141582110237
Author(s):  
Enrico Checcucci ◽  
Sabrina De Cillis ◽  
Daniele Amparore ◽  
Diletta Garrou ◽  
Roberta Aimar ◽  
...  

Objectives: To determine if standard biopsy still has a role in the detection of prostate cancer or clinically significant prostate cancer in biopsy-naive patients with positive multiparametric magnetic resonance imaging. Materials and methods: We extracted, from our prospective maintained fusion biopsy database, patients from March 2014 to December 2018. The detection rate of prostate cancer and clinically significant prostate cancer and complication rate were analysed in a cohort of patients who underwent fusion biopsy alone (group A) or fusion biopsy plus standard biopsy (group B). The International Society of Urological Pathology grade group determined on prostate biopsy with the grade group determined on final pathology among patients who underwent radical prostatectomy were compared. Results: Prostate cancer was found in 249/389 (64.01%) and 215/337 (63.8%) patients in groups A and B, respectively ( P=0.98), while the clinically significant prostate cancer detection rate was 57.8% and 55.1% ( P=0.52). No significant differences in complications were found. No differences in the upgrading rate between biopsy and final pathology finding after radical prostatectomy were recorded. Conclusions: In biopsy-naive patients, with suspected prostate cancer and positive multiparametric magnetic resonance imaging the addition of standard biopsy to fusion biopsy did not increase significantly the detection rate of prostate cancer or clinically significant prostate cancer. Moreover, the rate of upgrading of the cancer grade group between biopsy and final pathology was not affected by the addition of standard biopsy. Level of evidence: Not applicable for this multicentre audit.


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