Performance of multiparametric prostate magnetic resonance imaging validated by targeted and systematic transperineal biopsies.

Autor: Hsi RA; Seattle Cancer Care Alliance Peninsula Poulsbo Washington USA., Dinh TK; University of Washington Seattle Washington USA., Greer M; University of Washington Seattle Washington USA., Bensen C; Olympic Medical Center Port Angeles Washington USA., Mitchell MA; The Doctors Clinic Silverdale Washington USA., Li AY; The Doctors Clinic Silverdale Washington USA., Stamm A; The Doctors Clinic Silverdale Washington USA., Henne M; Rayus Imaging Poulsbo Washington USA.
Jazyk: angličtina
Zdroj: BJUI compass [BJUI Compass] 2022 Aug 19; Vol. 4 (1), pp. 96-103. Date of Electronic Publication: 2022 Aug 19 (Print Publication: 2023).
DOI: 10.1002/bco2.184
Abstrakt: Objective: To measure the performance of multiparametric (mp) magnetic resonance imaging (MRI) to identify intraprostatic tumour deposits using a systematic and targeted MR-guided transperineal prostate biopsy technique.
Materials and Methods: Patients underwent a combined systematic and targeted MR-guided transperineal biopsy procedure in the dorsal lithotomy position under general anaesthesia. Systematic biopsies were spaced 10 mm or less apart and additional biopsies targeted any Prostate Imaging-Reporting and Data System (PI-RADS) 3, 4 or 5 lesions identified on mpMRI. Cancer detection rates were calculated on a per patient and per lesion basis.
Results: A total of 125 patients underwent the biopsy procedure. The positive predictive value (PPV) of mpMRI per patient was 59% for any cancer and 49% for Gleason score (GS) ≥ 7 cancer. The negative predictive value (NPV) of mpMRI per patient was 67% for any cancer and 88% for GS ≥ 7 cancer. On a per lesion basis, the PPV of PI-RADS 3 lesions for any and GS ≥ 7 cancer was 24% and 10%. For PI-RADS 4 lesions it was 42% and 32%. For PI-RADS 5 lesions, it was 76% and 70%. MpMRI failed to identify GS ≥ 7 cancer found on systematic biopsy in 22% of patients.
Conclusion: Based on a combination of systematic and targeted transperineal prostate biopsies, mpMRI showed a high NPV and low PPV for GS ≥ 7 cancer on a per patient basis. The PPV of mpMRI on a per lesion basis increased with increasing PI-RADS score. However, there were a significant number of both false positive as well as false negative (mpMRI invisible) areas within the prostate that contained GS ≥ 7 cancer. Therefore, pathologic confirmation using both targeted and systematic mapping biopsy is necessary to accurately identify all intraprostatic tumour deposits.
Competing Interests: Richard A. Hsi—Boston Scientific, Provides professional expertise regarding use of SpaceOAR hydrogel, payment made to Hsi.
(© 2022 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)
Databáze: MEDLINE
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