Diagnostic Accuracy of a Rapid Biparametric MRI Protocol for Detection of Histologically Proven Prostate Cancer.

Urology

Department of Radiology, Case Western Reserve University, Cleveland, OH; Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Urology, Case Western Reserve University and University Hospitals Cleveland Medical Center, Cleveland, OH; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH. Electronic address:

Published: December 2018

Objective: To evaluate the performance of a rapid, low cost, noncontrast MRI examination as a secondary screening tool in detection of clinically significant prostate cancer.

Methods: In this prospective single institution study, 129 patients with elevated prostate-specific antigen levels or abnormal digital rectal examination findings underwent MRI with an abbreviated biparamatric MRI protocol consisting of high-resolution axial T2- and diffusion-weighted images. Index lesions were classified according to modified Prostate Imaging - Reporting and Data System (mPI-RADS) version 2.0. All patients underwent standard transrectal ultrasound-guided biopsy after MRI with the urologist being blinded to MRI results. Subsequently, all patients with suspicious lesions (mPI-RADS 3, 4, or 5) underwent cognitively guided targeted biopsy after discussion of MRI results with the urologist. Sensitivity and negative predictive value for identification of clinically significant prostate cancer (Gleason score 3+4 and above) were determined.

Results: Rapid biparametric MRI discovered 176 lesions identified in 129 patients. Rapid MRI detected clinically significant cancers with a sensitivity of 95.1% with a negative predictive value of 95.1% and positive predictive value of 53.2%, leading to a change in management in 10.8% of the patients. False negative rate of biparametric (bp) MRI was 4.7%.

Conclusion: We found that a bp-MRI examination can detect clinically significant lesions and changed patient management in 10.8% of the patients. A rapid MRI protocol can be used as a useful secondary screening tool in men presenting with suspicion of prostate cancer.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295224PMC
http://dx.doi.org/10.1016/j.urology.2018.08.032DOI Listing

Publication Analysis

Top Keywords

biparametric mri
12
mri protocol
12
prostate cancer
12
mri
11
rapid biparametric
8
secondary screening
8
screening tool
8
clinically prostate
8
129 patients
8
mri urologist
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!