Sage Journals: Discover world-class research

Abstract

Background

Multiparametric magnetic resonance imaging (mpMRI) can improve detection of clinically significant prostate cancer (csPCa).

Purpose

To compare mpMRI score subgroups to systematic transrectal ultrasound-guided biopsies (TRUS_bx) and prostate-specific antigen (PSA)-based findings for detection of csPCa in men undergoing repeat biopsies.

Material and Methods

MpMRI was performed prior to re-biopsy in 289 prospectively enrolled patients. All underwent repeat TRUS_bx followed by targeted biopsies (MRI_TB) of any mpMRI-identified lesion. MpMRI suspicion grade, PSA level, and density (PSAd) were compared with biopsy results and further matched to the radical prostatectomy (RP) specimen if available.

Results

PCa was detected in 128/289 (44%) patients with median age, PSA, and prior negative TRUS_bx of 64 (interquartile range [IQR] = 59–67), 12.0 ng/mL (IQR = 8.3–19.1), and 2 (IQR = 1–3), respectively. TRUS_bx detected PCa in 108/289 (37%) patients, of which 49 (45%) had insignificant cancer. MRI_TB was performed in 271/289 (94%) patients and detected PCa in 96 (35%) with 78 (81%) having csPCa. MpMRI scores showed a high association between suspicion level and biopsy results on both lesion and patient level (P < 0.001). MpMRI was better than PSA and PSAd (P < 0.001) to identify patients with missed csPCa. In total, 64/128 (50%) patients underwent RP; 60/64 had csPCa. MpMRI was significantly better in predicting csPCa on RP compared with TRUS_bx (P = 0.019) as MRI_TB and TRUS_bx correctly identified 47/60 (78%) and 35/60 (58%) patients, respectively.

Conclusion

MpMRI improves detection of missed csPCa and suspicion scores correlate well with biopsy and RP results on both patient and lesion level.

Keywords

Prostate primary neoplasm magnetic resonance imaging MRI ultrasound biopsy

Get full access to this article

View all access options for this article.

References

Vickers

Thompson

Klein

et al.

A commentary on PSA velocity and doubling time for clinical decisions in prostate cancer. Urology 2014; 83: 592–596.

Siddiqui

Rais-Bahrami

Turkbey

et al.

Comparison of MR/ultrasound fusion–guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 2015; 313: 390–397.

Schoots

Roobol

Nieboer

et al.

Magnetic resonance imaging–targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol 2015; 68: 438–450.

Hamoen

EHJ

de Rooij

Witjes

et al.

Use of the Prostate Imaging Reporting and Data System (PI-RADS) for prostate cancer detection with multiparametric magnetic resonance imaging: a diagnostic meta-analysis. Eur Urol 2015; 67: 1112–1121.

Moore

Robertson

Arsanious

et al.

Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol 2013; 63: 125–140.

Barentsz

Richenberg

Clements

et al.

ESUR prostate MR guidelines 2012. Eur Radiol 2012; 22: 746–757.

Portalez

Mozer

Cornud

et al.

Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients. Eur Urol 2012; 62: 986–996.

Siddiqui

Rais-Bahrami

Truong

et al.

Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol 2013; 64: 713–719.

Pokorny

de Rooij

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: 22–29.

10.

Boesen

Noergaard

Chabanova

et al.

Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy. Scand J Urol 2015; 49: 25–34.

11.

Dickinson

Ahmed

Allen

et al.

Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 2011; 59: 477–494.

12.

Weinreb

Barentsz

Choyke

et al.

PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol 2016; 69: 16–40.

13.

Epstein

Allsbrook

Amin

et al.

The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 2005; 29: 1228–1242.

14.

Sobin L, Gospodarowicz M WC. TNM Classification of Malignant Tumours. Urological Tumours. 7th edn. International Union Against Cancer. Hoboken, NJ: Wiley-Blackwell, 2009.

15.

Cash

Maxeiner

Stephan

et al.

The detection of significant prostate cancer is correlated with the Prostate Imaging Reporting and Data System (PI-RADS) in MRI/transrectal ultrasound fusion biopsy. World J Urol 2016; 34: 525–532.

16.

Delongchamps

Lefèvre

Bouazza

et al.

Detection of significant prostate cancer with magnetic resonance targeted biopsies–should transrectal ultrasound-magnetic resonance imaging fusion guided biopsies alone be a standard of care?

J Urol 2015; 193: 1198–1204.

17.

Langer

van der Kwast

Evans

et al.

Prostate cancer detection with multi-parametric MRI: logistic regression analysis of quantitative T2, diffusion-weighted imaging, and dynamic contrast-enhanced MRI. J Magn Reson Imaging 2009; 30: 327–334.

18.

Hoeks

CMA

Hambrock

Yakar

et al.

Transition zone prostate cancer: detection and localization with 3-T multiparametric MR imaging. Radiology 2013; 266: 207–217.

19.

Tewes

Mokov

Hartung

et al.

Standardized reporting of prostate MRI: comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and Version 2. PLoS One 2016; 11: e0162879–e0162879.

20.

De Visschere

Pattyn

Ost

et al.

Comparison of the Prostate Imaging Reporting and Data System (PI-RADS) Version 1 and 2 in a cohort of 245 patients with histopathological reference and long-term follow-up. J Belgian Soc Radiol 2016; 100: 108–108.

21.

Auer

Edlinger

Bektic

et al.

Performance of PI-RADS version 1 versus version 2 regarding the relation with histopathological results. World J Urol 2017; 35: 687–693.

22.

Rosenkrantz

Babb

Taneja

et al.

Proposed adjustments to PI-RADS version 2 decision rules: Impact on prostate cancer detection. Radiology 2017; 283: 119–129.

23.

Rais-Bahrami

Siddiqui

Vourganti

et al.

Diagnostic value of biparametric magnetic resonance imaging (MRI) as an adjunct to prostate-specific antigen (PSA)-based detection of prostate cancer in men without prior biopsies. BJU Int 2015; 115: 381–388.

24.

de Rooij

Hamoen

EHJ

Witjes

et al.

Accuracy of magnetic resonance imaging for local staging of prostate cancer: a diagnostic meta-analysis. Eur Urol 2016; 70: 233–245.

25.

Ahmed

. The index lesion and the origin of prostate cancer. N Engl J Med 2009; 361: 1704–1706.

26.

Baco

Ukimura

Rud

et al.

Magnetic resonance imaging–transectal ultrasound image-fusion biopsies accurately characterize the index tumor: correlation with step-sectioned radical prostatectomy specimens in 135 patients. Eur Urol 2015; 67: 787–794.

27.

Radtke

Schwab

Wolf

et al.

Multiparametric magnetic resonance imaging (MRI) and MRI-transrectal ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen. Eur Urol 2016; 70: 846–853.

28.

Tombal

. Toward the end of blind prostate biopsies? Eur Urol 2012; 62: 997–998.

29.

Sonn

Chang

Natarajan

et al.

Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen. Eur Urol 2014; 65: 809–815.

30.

Overduin

Fütterer

Barentsz

. MRI-guided biopsy for prostate cancer detection: a systematic review of current clinical results. Curr Urol Rep 2013; 14: 209–213.

Multiparametric MRI in men with clinical suspicion of prostate cancer undergoing repeat biopsy: a prospective comparison with clinical findings and histopathology

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

Get full access to this article

References