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. 2013 Nov;190(5):1721-1727.
doi: 10.1016/j.juro.2013.05.052. Epub 2013 May 29.

Utility of multiparametric magnetic resonance imaging suspicion levels for detecting prostate cancer

Soroush Rais-Bahrami  1 , M Minhaj Siddiqui  1 , Baris Turkbey  2 , Lambros Stamatakis  1 , Jennifer Logan  1 , Anthony N Hoang  1 , Annerleim Walton-Diaz  1 , Srinivas Vourganti  1 , Hong Truong  1 , Jochen Kruecker  3 , Maria J Merino  4 , Bradford J Wood  5 , Peter L Choyke  2 , Peter A Pinto  6
Affiliations

Utility of multiparametric magnetic resonance imaging suspicion levels for detecting prostate cancer

Soroush Rais-Bahrami et al. J Urol. 2013 Nov.

Abstract

Purpose: We determine the usefulness of multiparametric magnetic resonance imaging in detecting prostate cancer, with a specific focus on detecting higher grade prostate cancer.

Materials and methods: Prospectively 583 patients who underwent multiparametric magnetic resonance imaging and subsequent prostate biopsy at a single institution were evaluated. On multiparametric magnetic resonance imaging, lesions were identified and scored as low, moderate or high suspicion for prostate cancer based on a validated scoring system. Magnetic resonance/ultrasound fusion guided biopsies of magnetic resonance imaging lesions in addition to systematic 12-core biopsies were performed. Correlations between the highest assigned multiparametric magnetic resonance imaging suspicion score and presence of cancer and biopsy Gleason score on the first fusion biopsy session were assessed using univariate and multivariate logistic regression models. Sensitivity, specificity, negative predictive value and positive predictive value were calculated and ROC curves were developed to assess the discriminative ability of multiparametric magnetic resonance imaging as a diagnostic tool for various biopsy Gleason score cohorts.

Results: Significant correlations were found between age, prostate specific antigen, prostate volume, and multiparametric magnetic resonance imaging suspicion score and the presence of prostate cancer (p<0.0001). On multivariate analyses controlling for age, prostate specific antigen and prostate volume, increasing multiparametric magnetic resonance imaging suspicion was an independent prognosticator of prostate cancer detection (OR 2.2, p<0.0001). Also, incremental increases in multiparametric magnetic resonance imaging suspicion score demonstrated stronger associations with cancer detection in patients with Gleason 7 or greater (OR 3.3, p<0.001) and Gleason 8 or greater (OR 4.2, p<0.0001) prostate cancer. Assessing multiparametric magnetic resonance imaging as a diagnostic tool for all prostate cancer, biopsy Gleason score 7 or greater, and biopsy Gleason score 8 or greater separately via ROC analyses demonstrated increasing accuracy of multiparametric magnetic resonance imaging for higher grade disease (AUC 0.64, 0.69, and 0.72, respectively).

Conclusions: Multiparametric magnetic resonance imaging is a clinically useful modality to detect and characterize prostate cancer, particularly in men with higher grade disease.

Keywords: DRE; MP-MRI; MR; MR/US; MRI; NPV; PCa; PPV; PSA; TRUS; bGS; biopsy; biopsy Gleason score; digital rectal examination; magnetic resonance; magnetic resonance imaging; magnetic resonance/ultrasound; multiparametric magnetic resonance imaging; negative predictive value; neoplasm grading; positive predictive value; prostate; prostate cancer; prostate specific antigen; transrectal ultrasound.

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Figures

Figure 1
Figure 1
Diagram outlining inclusion and exclusion criteria for MP-MRI and MR/US fusion guided biopsy sessions included in data analysis.
Figure 2
Figure 2
Lesion based MP-MRI cancer suspicion scoring system.
Figure 3
Figure 3
ROC analysis of MP-MRI prediction of all, Gleason ≥7, and Gleason ≥8 prostate cancer found on biopsy.
See this image and copyright information in PMC

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References

    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10. - PubMed
    1. Egevad L, Granfors T, Karlberg L, Bergh A, Stattin P. Prognostic value of the Gleason score in prostate cancer. BJU Int. 2002;89:538. - PubMed
    1. Belas O, Hupertan V, Comperat E, Renard-Penna R, Mozer P, Bitker MO, et al. Low accuracy of routine ultrasound-guided systematic 12-core biopsies in prostate tumor mapping. Can J Urol. 2012;19:6366. - PubMed
    1. Kvale R, Moller B, Wahlqvist R, Fossa SD, Berner A, Busch C, et al. Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study. BJU Int. 2009;103:1647. - PubMed
    1. Conti SL, Dall’era M, Fradet V, Cowan JE, Simko J, Carroll PR. Pathological outcomes of candidates for active surveillance of prostate cancer. J Urol. 2009;181:1628. - PubMed

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