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The Diagnostic Performance of Multiparametric Magnetic Resonance Imaging to Detect Significant Prostate Cancer

2015; Lippincott Williams & Wilkins; Volume: 195; Issue: 5 Linguagem: Inglês

10.1016/j.juro.2015.10.140

1527-3792

James Thompson, Pim J. van Leeuwen, Daniel Moses, R. Shnier, Phillip Brenner, Warick Delprado, Marley Pulbrook, Maret Böhm, Anne-Marie Haynes, Andrew Hayen, Phillip D. Stricker,

Urologic and reproductive health conditions

No AccessJournal of UrologyAdult Urology1 May 2016The Diagnostic Performance of Multiparametric Magnetic Resonance Imaging to Detect Significant Prostate Cancer J.E. Thompson, P.J. van Leeuwen, D. Moses, R. Shnier, P. Brenner, W. Delprado, M. Pulbrook, M. Böhm, A.M. Haynes, A. Hayen, and P.D. Stricker J.E. ThompsonJ.E. Thompson St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , P.J. van LeeuwenP.J. van Leeuwen St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , D. MosesD. Moses School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , R. ShnierR. Shnier School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , P. BrennerP. Brenner St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , W. DelpradoW. Delprado University of Notre Dame, Darlinghurst, New South Wales, Australia More articles by this author , M. PulbrookM. Pulbrook Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author , M. BöhmM. Böhm Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author , A.M. HaynesA.M. Haynes Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author , A. HayenA. Hayen School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author , and P.D. StrickerP.D. Stricker St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.10.140AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assess the accuracy of multiparametric magnetic resonance imaging for significant prostate cancer detection before diagnostic biopsy in men with an abnormal prostate specific antigen/digital rectal examination. Materials and Methods: A total of 388 men underwent multiparametric magnetic resonance imaging, including T2-weighted, diffusion weighted and dynamic contrast enhanced imaging before biopsy. Two radiologists used PI-RADS to allocate a score of 1 to 5 for suspicion of significant prostate cancer (Gleason 7 with more than 5% grade 4). PI-RADS 3 to 5 was considered positive. Transperineal template guided mapping biopsy of 18 regions (median 30 cores) was performed with additional manually directed cores from magnetic resonance imaging positive regions. The anatomical location, size and grade of individual cancer areas in the biopsy regions (18) as the primary outcome and in prostatectomy specimens (117) as the secondary outcome were correlated to the magnetic resonance imaging positive regions. Results: Of the 388 men who were enrolled in the study 344 were analyzed. Multiparametric magnetic resonance imaging was positive in 77.0% of patients, 62.5% had prostate cancer and 41.6% had significant prostate cancer. The detection of significant prostate cancer by multiparametric magnetic resonance imaging had a sensitivity of 96%, specificity of 36%, negative predictive value of 92% and positive predictive value of 52%. Adding PI-RADS to the multivariate model, including prostate specific antigen, digital rectal examination, prostate volume and age, improved the AUC from 0.776 to 0.879 (p <0.001). Anatomical concordance analysis showed a low mismatch between the magnetic resonance imaging positive regions and biopsy positive regions (4 [2.9%]), and the significant prostate cancer area in the radical prostatectomy specimen (3 [3.3%]). Conclusions: In men with an abnormal prostate specific antigen/digital rectal examination, multiparametric magnetic resonance imaging detected significant prostate cancer with an excellent negative predictive value and moderate positive predictive value. The use of multiparametric magnetic resonance imaging to diagnose significant prostate cancer may result in a substantial number of unnecessary biopsies while missing a minimum of significant prostate cancers. References 1 : EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol2014; 65: 124. Google Scholar 2 : American Urological Association (AUA) guideline on prostate cancer detection: process and rationale. BJU Int2013; 112: 543. Google Scholar 3 : Early detection of prostate cancer in 2007. Part 1: PSA and PSA kinetics. Eur Urol2008; 53: 468. Google Scholar 4 : Optimization of initial prostate biopsy in clinical practice: sampling, labeling and specimen processing. J Urol2013; 189: 2039. Link, Google Scholar 5 : Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades. Eur Urol2012; 61: 1019. Google Scholar 6 : Transperineal biopsy prostate cancer detection in first biopsy and repeat biopsy after negative transrectal ultrasound-guided biopsy: the Victorian Transperineal Biopsy Collaboration experience. BJU Int2015; 116: 568. Google Scholar 7 : Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol2014; 66: 22. Google Scholar 8 : Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? A systematic review of the literature. Eur Urol2015; 68: 1045. Google Scholar 9 : Multi-parametric magnetic resonance imaging to rule-in and rule-out clinically important prostate cancer in men at risk: a cohort study. Urol Int2011; 87: 49. Google Scholar 10 : In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging, is a 12-core biopsy still necessary in addition to a targeted biopsy?. BJU Int2015; 115: 562. Google Scholar 11 : A prospective, blinded comparison of magnetic resonance (MR) imaging-ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the PROFUS trial. Eur Urol2014; 66: 343. Google Scholar 12 : Prostate saturation biopsy in the reevaluation of microfocal prostate cancer. J Urol2006; 176: 961. Link, Google Scholar 13 : Prospective evaluation of an extended 21-core biopsy scheme as initial prostate cancer diagnostic strategy. Eur Urol2014; 65: 154. Google Scholar 14 : Standards of Reporting for MRI-targeted Biopsy Studies (START) of the prostate: recommendations from an international working group. Eur Urol2013; 64: 544. Google Scholar 15 : Multiparametric magnetic resonance imaging guided diagnostic biopsy detects significant prostate cancer and could reduce unnecessary biopsies and over detection: a prospective study. J Urol2014; 192: 67. Link, Google Scholar 16 : ESUR prostate MR guidelines 2012. Eur Radiol2012; 22: 746. Google Scholar 17 : Prognostic significance of pathologic features in localized prostate cancer treated with radical prostatectomy: implications for staging systems and predictive models. J Clin Oncol2001; 19: 3692. Google Scholar 18 : Detection of the index tumour and tumour volume in prostate cancer using T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) alone. BJU Int2014; 114: E32. Google Scholar 19 : Prostate cancer: value of multiparametric MR imaging at 3 T for detection–histopathologic correlation. Radiology2010; 255: 89. Google Scholar 20 : Reply to Yaalini Shanmugabavan, Stephanie Guillaumier and Hashim U. Ahmed's letter to the editor re: Morgan R. Pokorny, Maarten de Rooij, Earl Duncan, et al: Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 2014;66:22–9. Eur Urol2015; 67: e54. Google Scholar 21 : Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol2010; 183: 520. Link, Google Scholar 22 : Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol2013; 64: 713. Google Scholar 23 : The role of focal therapy in the management of localised prostate cancer: a systematic review. Eur Urol2014; 66: 732. Google Scholar 24 : Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol2012; 62: 902. Google Scholar 25 : The role of magnetic resonance imaging in delineating clinically significant prostate cancer. Urology2014; 83: 369. Google Scholar 26 : Quantitative assessment of T2-weighted MRI to better identify patients with prostate cancer in a screening population. J Urol2015; 193: e739. abstract MP60-04. Link, Google Scholar 27 : Accuracy of primary systematic template guided transperineal biopsy of the prostate for locating prostate cancer: a comparison with radical prostatectomy specimens. J Urol2012; 187: 2044. Link, Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byDoan P, Scheltema M, Amin A, Shnier R, Geboers B, Gondoputro W, Moses D, van Leeuwen P, Haynes A, Matthews J, Brenner P, O’Neill G, Yuen C, Delprado W, Stricker P and Thompson J (2022) Final Analysis of the Magnetic Resonance Imaging in Active Surveillance TrialJournal of Urology, VOL. 208, NO. 5, (1028-1036), Online publication date: 1-Nov-2022.Pagniez M, Kasivisvanathan V, Puech P, Drumez E, Villers A and Olivier J (2020) Predictive Factors of Missed Clinically Significant Prostate Cancers in Men with Negative Magnetic Resonance Imaging: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 204, NO. 1, (24-32), Online publication date: 1-Jul-2020.Amin A, Scheltema M, Shnier R, Blazevski A, Moses D, Cusick T, Siriwardena A, Yuen B, van Leeuwen P, Haynes A, Matthews J, Brenner P, O'Neill G, Yuen C, Delprado W, Stricker P and Thompson J (2019) The Magnetic Resonance Imaging in Active Surveillance (MRIAS) Trial: Use of Baseline Multiparametric Magnetic Resonance Imaging and Saturation Biopsy to Reduce the Frequency of Surveillance Prostate BiopsiesJournal of Urology, VOL. 203, NO. 5, (910-917), Online publication date: 1-May-2020.Thompson J, Sridhar A, Tan W, Freeman A, Haider A, Allen C, Moore C, Orczyk C, Mazzon G, Khetrapal P, Shaw G, Rajan P, Mohammed A, Briggs T, Nathan S, Kelly J and Sooriakumaran P (2019) Pathological Findings and Magnetic Resonance Imaging Concordance at Salvage Radical Prostatectomy for Local Recurrence following Partial Ablation Using High Intensity Focused UltrasoundJournal of Urology, VOL. 201, NO. 6, (1134-1143), Online publication date: 1-Jun-2019.Kornberg Z, Cowan J, Westphalen A, Cooperberg M, Chan J, Zhao S, Shinohara K and Carroll P (2019) Genomic Prostate Score, PI-RADS™ version 2 and Progression in Men with Prostate Cancer on Active SurveillanceJournal of Urology, VOL. 201, NO. 2, (300-307), Online publication date: 1-Feb-2019.Ullrich T, Quentin M, Arsov C, Schmaltz A, Tschischka A, Laqua N, Hiester A, Blondin D, Rabenalt R, Albers P, Antoch G and Schimmöller L (2017) Risk Stratification of Equivocal Lesions on Multiparametric Magnetic Resonance Imaging of the ProstateJournal of Urology, VOL. 199, NO. 3, (691-698), Online publication date: 1-Mar-2018.Boesen L, Nørgaard N, Løgager V and Thomsen H (2017) Clinical Outcome Following Low Suspicion Multiparametric Prostate Magnetic Resonance Imaging or Benign Magnetic Resonance Imaging Guided Biopsy to Detect Prostate CancerJournal of Urology, VOL. 198, NO. 2, (310-315), Online publication date: 1-Aug-2017.Narayan V, Bozorgmehri S, Ellen J, Canales M, Canales B and Bird V (2016) Evaluating Region of Interest Measurement Strategies to Characterize Upper Urinary Tract Stones on Computerized TomographyJournal of Urology, VOL. 197, NO. 3 Part 1, (715-722), Online publication date: 1-Mar-2017.Nam R, Wallis C, Stojcic-Bendavid J, Milot L, Sherman C, Sugar L and Haider M (2016) A Pilot Study to Evaluate the Role of Magnetic Resonance Imaging for Prostate Cancer Screening in the General PopulationJournal of Urology, VOL. 196, NO. 2, (361-366), Online publication date: 1-Aug-2016.Tosoian J (2016) Editorial CommentJournal of Urology, VOL. 195, NO. 6, (1771-1772), Online publication date: 1-Jun-2016. Volume 195Issue 5May 2016Page: 1428-1435Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsprostate-specific antigenearly detection of cancermagnetic resonance imagingprostatic neoplasmsbiopsyMetricsAuthor Information J.E. Thompson St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author P.J. van Leeuwen St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author D. Moses School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author R. Shnier School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author P. Brenner St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author W. Delprado University of Notre Dame, Darlinghurst, New South Wales, Australia More articles by this author M. Pulbrook Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author M. Böhm Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author A.M. Haynes Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia More articles by this author A. Hayen School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author P.D. Stricker St. Vincent’s Prostate Cancer Centre, Darlinghurst, New South Wales, Australia Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia School of Medicine, University of New South Wales, Kensington, New South Wales, Australia More articles by this author Expand All Advertisement PDF downloadLoading ...