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. 2023 Jan-Mar;15(1):54-59.
doi: 10.4103/ua.ua_22_22. Epub 2022 Nov 8.

False-positive magnetic resonance imaging prostate cancer correlates and clinical implications

Mostafa A Arafa  1   2 , Danny M Rabah  1   3 , Farrukh Khan  3 , Karim Hamda Farhat  1 , Nahla Khamis Ibrahim  2   4 , Alanoud A Albekairi  5
Affiliations

False-positive magnetic resonance imaging prostate cancer correlates and clinical implications

Mostafa A Arafa et al. Urol Ann. 2023 Jan-Mar.

Abstract

Background: False-positive (FP) multiparametric magnetic resonance imaging (MPMRI) obscures and swift needless biopsies in men with a high prostate-specific antigen.

Materials and methods: This was a retrospective study, in which all patients who had been exposed to consecutive MP-MRI of the prostate combined with transrectal ultrasound-guided-magnetic resonance imaging fusion-guided prostate biopsy between 2017 and 2020 were involved in the study. The FP was measured as the number of biopsies that did not encompass prostate cancer divided by the whole number of biopsies.

Results: The percentage of FP cases was 51.1%, the highest percentage was found in Prostate Imaging-Reporting and Data System (PI-RADs) 3 (37.7%) and the lowest was detected in PI-RAD 5 (14.5%). Those with FP biopsies are younger, and their total prostate antigen (PSA) and PSA density (PSAD) are significantly lesser. The area under the curve PSAD, age, and total PSA are 0.76, 0.74, and 0.69, respectively. An optimum PSAD value of 0.135 was chosen as a cutoff because it showed the highest sum of sensitivity and specificity, 68% and 69%, respectively.

Conclusion: FP results of mpMRI were detected in more than half of our sample, more than one-third were presented in Pi-RAD3, improved imaging techniques to decrease FP rates are highly needed.

Keywords: PIRADs; prostate cancer; transrectal ultrasound-guided biopsy- magnetic resonance imaging fusion-guided prostate biopsy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of false positive (biopsy negative cases) by PI-RADS. PI-RADS: Prostate imaging reporting and data system
Figure 2
Figure 2
ROC curve for positive biopsy cases
See this image and copyright information in PMC

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