Value of prostate multiparametric magnetic resonance imaging for predicting biopsy results in first or repeat biopsy
| Autor: | T. Sanzalone, Florence Mège-Lechevallier, Muriel Rabilloud, Marc Colombel, Flavie Bratan, Hocine Habchi, Sebastien Crouzet, G. Pagnoux, Olivier Rouvière, A. Paye |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Prostate biopsy Biopsy Predictive Value of Tests Prostate medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Multiparametric Magnetic Resonance Imaging Aged Receiver operating characteristic medicine.diagnostic_test Repeat biopsy business.industry Prostatic Neoplasms Cancer General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery SSS medicine.anatomical_structure Radiology business |
| Zdroj: | Clinical Radiology. 69:e120-e128 |
| ISSN: | 0009-9260 |
| Popis: | Aim To assess multiparametric magnetic resonance imaging (mp-MRI) in predicting prostate biopsy results. Materials and methods Patients who underwent mp-MRI prior to prostate biopsy were prospectively included. The prostate was subdivided into 14 sectors and mp-MRI findings assessed using a five-level subjective suspicion score (SSS). Biopsy included targeted samples of abnormal sectors and systematic samples of normal peripheral zone sectors. Results Two hundred and eighty-eight patients were included [153 biopsy naive, 135 with negative ( n = 51) or positive ( n = 84) prior biopsy]. Biopsy was positive in 168 patients. mp-MRI area under the receiver operating characteristic (ROC) curve (AUC) was 69.1% (95% CI: 67.1–70.9%), 72.5% (95% CI: 69.5–76%), and 73.8% (95% CI: 68.3–79.3%) at per sector, per lobe, and per patient analysis, respectively. At the per sector level, the AUC was significantly larger if detection was limited to cancers with a Gleason score of ≥7 (72.6%; 95% CI: 69.8–75.8%; p 0.01) or ≥8 (87.1%; 95% CI: 78.3–95.7%; p 0.01). mp-MRI performance was significantly influenced by prostate volume ( p = 0.02), the presence of a concordant hypoechoic area ( p 0.001), but not by prostate-specific antigen (PSA) value, status of prior biopsy, or radiologists' experience. SSS was significantly associated with the Gleason score in true-positive lobes and patients ( p 0.0001). Using a SSS threshold of ≥3, cancer was missed in 13/102 lobes and 4/72 patients with cancers of Gleason score ≥7. Conclusion mp-MRI provides a good detection of cancers with a Gleason score of ≥7 in candidates suitable for prostate biopsy. |
| Databáze: | OpenAIRE |
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