3.0 T multiparametric prostate MRI using pelvic phased-array coil

Utility for tumor detection prior to biopsy

Andrew B. Rosenkrantz, Thais C. Mussi, Michael S Borofsky, Stephen S. Scionti, Michael Grasso, Samir S. Taneja

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To evaluate the role of multiparametric magnetic resonance imaging (MRI) performed in men without a biopsy-proven diagnosis of prostate cancer using follow-up biopsy as the reference standard. Materials and methods: Forty-two patients without biopsy-proven cancer and who underwent MRI were included. In all patients, MRI was performed at 3T using a pelvic phased-array coil and included T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Thirteen had undergone no previous biopsy, and 29 had undergone at least 1 previous negative biopsy. All patients underwent prostate biopsy following MRI. Two fellowship-trained radiologists in consensus reviewed all cases and categorized each lobe as positive or negative for tumor. These interpretations were correlated with findings on post-MRI biopsy. Results: Follow-up biopsy was positive in 23 lobes in 15 patients (36% of study cohort). On a per-patient basis, MRI had a sensitivity of 100%, specificity of 74%, positive predictive value (PPV) of 68%, and negative predictive value (NPV) of 100%. On a per-lobe basis, MRI had a sensitivity of 65%, specificity of 84%, PPV of 60%, and NPV of 86%. There was a nearly significant association between Gleason score and tumor detection on MRI (P = 0.072). Conclusions: In our sample, MRI had 100% sensitivity in predicting the presence of tumor on subsequent biopsy on a per-patient basis, suggesting a possible role for MRI in selecting patients with an elevated prostatic specific antigen (PSA) to undergo prostate biopsy. However, MRI had weaker specificity for prediction of a subsequent positive biopsy, as well as weaker sensitivity for tumor on a per-lobe basis, indicating that in patients with a positive MRI result, tissue sampling remains necessary for confirmation of the diagnosis as well as for treatment planning.

Original languageEnglish (US)
Pages (from-to)1430-1435
Number of pages6
JournalUrologic Oncology: Seminars and Original Investigations
Volume31
Issue number8
DOIs
StatePublished - Nov 1 2013
Externally publishedYes

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Prostate
Magnetic Resonance Imaging
Biopsy
Neoplasms
Sensitivity and Specificity
Neoplasm Grading
Prostatic Neoplasms
Cohort Studies
Antigens

Keywords

  • Biopsy
  • MRI
  • Prostate cancer

Cite this

3.0 T multiparametric prostate MRI using pelvic phased-array coil : Utility for tumor detection prior to biopsy. / Rosenkrantz, Andrew B.; Mussi, Thais C.; Borofsky, Michael S; Scionti, Stephen S.; Grasso, Michael; Taneja, Samir S.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 31, No. 8, 01.11.2013, p. 1430-1435.

Research output: Contribution to journalArticle

Rosenkrantz, Andrew B. ; Mussi, Thais C. ; Borofsky, Michael S ; Scionti, Stephen S. ; Grasso, Michael ; Taneja, Samir S. / 3.0 T multiparametric prostate MRI using pelvic phased-array coil : Utility for tumor detection prior to biopsy. In: Urologic Oncology: Seminars and Original Investigations. 2013 ; Vol. 31, No. 8. pp. 1430-1435.
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abstract = "Objective: To evaluate the role of multiparametric magnetic resonance imaging (MRI) performed in men without a biopsy-proven diagnosis of prostate cancer using follow-up biopsy as the reference standard. Materials and methods: Forty-two patients without biopsy-proven cancer and who underwent MRI were included. In all patients, MRI was performed at 3T using a pelvic phased-array coil and included T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Thirteen had undergone no previous biopsy, and 29 had undergone at least 1 previous negative biopsy. All patients underwent prostate biopsy following MRI. Two fellowship-trained radiologists in consensus reviewed all cases and categorized each lobe as positive or negative for tumor. These interpretations were correlated with findings on post-MRI biopsy. Results: Follow-up biopsy was positive in 23 lobes in 15 patients (36{\%} of study cohort). On a per-patient basis, MRI had a sensitivity of 100{\%}, specificity of 74{\%}, positive predictive value (PPV) of 68{\%}, and negative predictive value (NPV) of 100{\%}. On a per-lobe basis, MRI had a sensitivity of 65{\%}, specificity of 84{\%}, PPV of 60{\%}, and NPV of 86{\%}. There was a nearly significant association between Gleason score and tumor detection on MRI (P = 0.072). Conclusions: In our sample, MRI had 100{\%} sensitivity in predicting the presence of tumor on subsequent biopsy on a per-patient basis, suggesting a possible role for MRI in selecting patients with an elevated prostatic specific antigen (PSA) to undergo prostate biopsy. However, MRI had weaker specificity for prediction of a subsequent positive biopsy, as well as weaker sensitivity for tumor on a per-lobe basis, indicating that in patients with a positive MRI result, tissue sampling remains necessary for confirmation of the diagnosis as well as for treatment planning.",
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T1 - 3.0 T multiparametric prostate MRI using pelvic phased-array coil

T2 - Utility for tumor detection prior to biopsy

AU - Rosenkrantz, Andrew B.

AU - Mussi, Thais C.

AU - Borofsky, Michael S

AU - Scionti, Stephen S.

AU - Grasso, Michael

AU - Taneja, Samir S.

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N2 - Objective: To evaluate the role of multiparametric magnetic resonance imaging (MRI) performed in men without a biopsy-proven diagnosis of prostate cancer using follow-up biopsy as the reference standard. Materials and methods: Forty-two patients without biopsy-proven cancer and who underwent MRI were included. In all patients, MRI was performed at 3T using a pelvic phased-array coil and included T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Thirteen had undergone no previous biopsy, and 29 had undergone at least 1 previous negative biopsy. All patients underwent prostate biopsy following MRI. Two fellowship-trained radiologists in consensus reviewed all cases and categorized each lobe as positive or negative for tumor. These interpretations were correlated with findings on post-MRI biopsy. Results: Follow-up biopsy was positive in 23 lobes in 15 patients (36% of study cohort). On a per-patient basis, MRI had a sensitivity of 100%, specificity of 74%, positive predictive value (PPV) of 68%, and negative predictive value (NPV) of 100%. On a per-lobe basis, MRI had a sensitivity of 65%, specificity of 84%, PPV of 60%, and NPV of 86%. There was a nearly significant association between Gleason score and tumor detection on MRI (P = 0.072). Conclusions: In our sample, MRI had 100% sensitivity in predicting the presence of tumor on subsequent biopsy on a per-patient basis, suggesting a possible role for MRI in selecting patients with an elevated prostatic specific antigen (PSA) to undergo prostate biopsy. However, MRI had weaker specificity for prediction of a subsequent positive biopsy, as well as weaker sensitivity for tumor on a per-lobe basis, indicating that in patients with a positive MRI result, tissue sampling remains necessary for confirmation of the diagnosis as well as for treatment planning.

AB - Objective: To evaluate the role of multiparametric magnetic resonance imaging (MRI) performed in men without a biopsy-proven diagnosis of prostate cancer using follow-up biopsy as the reference standard. Materials and methods: Forty-two patients without biopsy-proven cancer and who underwent MRI were included. In all patients, MRI was performed at 3T using a pelvic phased-array coil and included T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Thirteen had undergone no previous biopsy, and 29 had undergone at least 1 previous negative biopsy. All patients underwent prostate biopsy following MRI. Two fellowship-trained radiologists in consensus reviewed all cases and categorized each lobe as positive or negative for tumor. These interpretations were correlated with findings on post-MRI biopsy. Results: Follow-up biopsy was positive in 23 lobes in 15 patients (36% of study cohort). On a per-patient basis, MRI had a sensitivity of 100%, specificity of 74%, positive predictive value (PPV) of 68%, and negative predictive value (NPV) of 100%. On a per-lobe basis, MRI had a sensitivity of 65%, specificity of 84%, PPV of 60%, and NPV of 86%. There was a nearly significant association between Gleason score and tumor detection on MRI (P = 0.072). Conclusions: In our sample, MRI had 100% sensitivity in predicting the presence of tumor on subsequent biopsy on a per-patient basis, suggesting a possible role for MRI in selecting patients with an elevated prostatic specific antigen (PSA) to undergo prostate biopsy. However, MRI had weaker specificity for prediction of a subsequent positive biopsy, as well as weaker sensitivity for tumor on a per-lobe basis, indicating that in patients with a positive MRI result, tissue sampling remains necessary for confirmation of the diagnosis as well as for treatment planning.

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KW - MRI

KW - Prostate cancer

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