Efficacy of 3T Multiparametric MR Imaging followed by 3T in-Bore MR-Guided Biopsy for Detection of Clinically Significant Prostate Cancer Based on PIRADSv2.1 Score
| Autor: | Ely Felker, Preeti Ahuja, Melina Hosseiny, Afshin Azadikhah, David S.K. Lu, Steven S. Raman, Danielle Ponzini, James Sayre, Voraparee Suvannarerg |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Image-Guided Biopsy Male medicine.medical_specialty Magnetic Resonance Imaging Interventional 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Mr guided biopsy Predictive Value of Tests Prostate Biopsy medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Prostatic Neoplasms Reproducibility of Results Magnetic resonance imaging Odds ratio Middle Aged medicine.disease Confidence interval Diffusion Magnetic Resonance Imaging medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort Radiology Neoplasm Grading Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular and Interventional Radiology. 31:1619-1626 |
| ISSN: | 1051-0443 |
| Popis: | Purpose To evaluate the diagnostic yield of 3T in-bore magnetic resonance-guided biopsy (3T IB-MRGB) for detection of clinically significant prostate cancer (csPCa), based on assessment using the Prostate Imaging Reporting and Data System version 2.1 (PIRADSv2.1). Materials and Methods This single-center study examined individuals who underwent 3T multiparametric prostate magnetic resonance (MR) imaging and subsequent 3T IB-MRGB. The final study cohort included 379 men (with 475 targets) divided into 3 subcohorts: biopsy-naive men (n = 123), individuals with a history of negative trans-rectal-ultrasonography (TRUS) biopsy results (n = 106), and men with low-grade PCa under active surveillance (n = 150). csPCa was defined as having a Gleason score (GS) ≥3+4. Results 3T IB-MRGB detected PCa and csPCa in 69.1% (262 of 379) and 50.3% (193 of 379) of patients, respectively. The PCa and csPCa detection rates per target were 64.2% (305 of 475) and 43.8% (208 of 475), respectively. The rate of urosepsis, treated with intravenous antibiotics, was 1% (4 patients). In TRUS biopsy negative results and biopsy-naive subcohorts, csPCa was found in 36.8% (39 of 106) and 52.8% (65 of 123), respectively. In 50.7% (76 of 150) of the active surveillance subcohort, 3T IB-MRGB upgraded the GS assigned in prior TRUS biopsies. Positive predictive values of PIRADSv2.1 categories 3, 4, and 5 for csPCa detection were 24.8%, 44.4%, and 67.1%, respectively. Higher PIRADSv2.1 categories were significantly associated with PCa (odds ratio [OR], 3.97; 95% confidence interval [CI], 2.98–5.28) and csPCa (OR, 1.41; 95% CI, 1.03–1.94) detection. Of 137 PIRADSv2 category 3 lesions, 28 were downgraded to PIRADSv2.1 category 2, in which there were no occurrences of csPCa in histology. Conclusions Use of 3T IB-MRGB resulted in detection of csPCa in 50.9% of individuals. 3T IB-MRGB has a high diagnostic yield in individuals with negative TRUS biopsy results and those under active surveillance. The PIRADSv2.1 category is a strong predictor of PCa and csPCa detection. |
| Databáze: | OpenAIRE |
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