Impact of PI-RADS v2 on indication of prostate biopsy

Rozas, George de Queiroz; Saad, Lucas Scatigno; Melo, Homero José de Farias e; Gabrielle, Henrique Armando Azevedo; Szejnfeld, Jacob

doi:10.1590/s1677-5538.ibju.2018.0564

Cited by 11 publications

(5 citation statements)

References 30 publications

(31 reference statements)

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“…Conversely, three retrospective studies reported NPVs ranging from 96.5% to 99% [24,25,28]. However, although all three studies included a significant number of men with non-suspicious mpMRIs (114, 100 and 201, respectively), the NPVs described were likely driven by the majority of patients with previous negative biopsies and the very low rate of significant cancers diagnosed among them.…”

Section: Mixed Populationsmentioning

confidence: 95%

What to expect from a non-suspicious prostate MRI? A review

Fiard

Norris

Nguyen

et al. 2020

Progrès en Urologie

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Abbreviations mpMRI Multiparametric Magnetic Resonance Imaging NPV Negative Predictive Value Résumé Contexte : La réalisation d'une IRM multiparamétrique (IRMmp) est désormais recommandée avant la réalisation de biopsies prostatiques. En revanche, la conduite à tenir en présence d'une IRMmp non-suspecte (Score Likert ou PIRADS 1-2) est toujours débattue. Objectifs : Faire une synthèse de la littérature récente pour répondre à trois questions. 1) Faut-il réaliser des biopsies systématisées en présence d'une IRMmp non suspecte ? 2) Quels facteurs prédictifs permettent de définir les patients candidats à une biopsie systématisée ? 3) Le manque de visibilité de certains cancers peut-elle être expliquée et quelles en sont les conséquences cliniques ? Sources : Une revue narrative de la littérature a été réalisée à partir des bases de données Medline utilisant deux recherches avec les termes "MRI" AND "prostate cancer" AND ("diagnosis" OR "biopsy") AND ("non-suspicious" OR "negative" OR "invisible") ; "prostate cancer MRI visible". Les références des articles sélectionnés ont été analysées à la recherche d'articles supplémentaires. Sélection des études : Les études publiées dans les 5 dernières années en anglais ont été analysées et retenues si les données disponibles permettaient de répondre à l'une des 3 questions posées. Résultats : Considérant les cancers de grade ISUP ³ 2 cliniquement significatifs, la valeur prédictive négative (VPN) de l'IRMmp était comprise entre 76% et 99%, dépendante de la prévalence du cancer et du type de test de référence utilisé. La VPN était plus élevée chez les patients aux antécédents de biopsie négative (88-96%), et plus faible chez les patients en surveillance active (85-90%). La densité de PSA (PSAd) avec un seuil de PSAd<0.15ng/ml/ml était le facteur prédictif le plus étudié et le plus pertinent associé à l'IRMmp pour éliminer un cancer significatif. Enfin, les tumeurs non visibles à l'IRMmp présentaient des différences au niveau histopathologique et génétique, conférant un intérêt clinique à la visibilité IRM. Limites du travail : La plupart des données proviennent de centres experts et les résultats peuvent ne pas être reproductibles en dehors. Conclusion : L'IRMmp fait preuve de performances diagnostiques élevées pour éliminer un cancer cliniquement significatif. La densité de PSA peut être utilisée pour sélectionner patients devant avoir une biopsie. Une meilleure connaissance des mécanismes à l'origine de la visibilité du cancer devrait aider le développement de nomogrammes et biomarqueurs plus précis.

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Section: Mixed Populationsmentioning

confidence: 95%

What to expect from a non-suspicious prostate MRI? A review

Fiard

Norris

Nguyen

et al. 2020

Progrès en Urologie

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“…The results were similar to previously published studies in literature. [ 9 13 14 ] Another significant aspect of our results was that all patients with clinically significant tumors had PI-RADS v2 3–5 score, signifying that PI-RADS v2 score 3 can be considered as cutoff value for biopsy. Similar conclusions were also derived by Rozas et al .…”

Section: Discussionmentioning

confidence: 73%

“…Similar conclusions were also derived by Rozas et al . [ 9 ] in their study. Both the false-negative tumors in our study were low-grade cancers with Gleason score 6.…”

Section: Discussionmentioning

confidence: 99%

“…[ 8 ] In 2012, the European Society of Urogenital Radiology published a series of guidelines recommending the interpretation of mp-MRI images to describe and obtain a report called Prostate Imaging Reporting and Data System. [ 9 ] Later, prostate imaging reporting and data system (PI-RADS) was improved and updated to PI-RADS v2 version 2 (PI-RADS v2) by American College of Radiologists, EUSR and AdMe Tech Foundation. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

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Correlation between prostate imaging reporting and data system version 2, prostate-specific antigen levels, and local staging in biopsy-proven carcinoma prostate: A retrospective study

Gupta

Mahajan

Sharma

2021

Int J App Basic Med Res

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Background: Multi-parametric magnetic resonance imaging (mp-MRI) is a promising tool in the diagnosis of clinically significant prostate cancer. Morphologic assessment using T2-weighted (T2W) images and functional assessment with diffusion-weighted imaging is the cornerstone for the diagnosis of prostate cancer on mp-MRI. Aim/Objectives: The aim of this study is to evaluate the role of mp-MRI based prostate imaging reporting and data system version 2 (PI-RADS v2) for the assessment of prostate cancer and its correlation with serum prostate specific antigen (S.PSA) levels, local (T) staging on MRI and histopathology. Materials and Methods: The study was carried out from June 2019 to February 2020. All patients with raised S.PSA levels and abnormal digital rectal examination who underwent mp-MRI of the prostate were included. MRI findings were characterized on the basis of PI-RADS v2 grading. All the patients underwent biopsy and histopathology. The score was correlated with S.PSA levels and the local stage of disease on MRI. Statistical analysis was performed, and results interpreted. Results: Carcinoma prostate was reported in 32/33 cases on biopsy. A significant correlation was observed between PI-RADS v2 score and S.PSA Levels and between PI-RADS v2 score and T stage of disease in our study. MRI was highly sensitive (93.75%) and specific (100%) in the diagnosis of prostate cancer in our study. Conclusions: Significant correlation between lesion score on PI-RADS v2 with the local stage and S.PSA levels was seen, thus signifying the importance of mp-MRI in detecting clinically significant prostate cancer. Diffusion-weighted and T2W sequences were the primary diagnostic sequence for the prostate cancer with no additional role of dynamic contrast enhanced sequences.

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“… 6 Multiparameter magnetic resonance imaging (mpMRI) has been increasingly used to diagnose patients with PCa. 7 , 8 In 2012, the European Society of Urogenital Radiology (ESUR) established a series of guidelines for the interpretation of mpMRI images using a structured reporting scheme called Prostate Imaging Reporting and Data System (PIRADS). 9 In 2015, the American College of Radiologists, EUSR and the AdMeTech Foundation improved and updated PIRADS to version 2 (PIRADS V2).…”

Section: Introductionmentioning

confidence: 99%

New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study

et al. 2023

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This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.

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Impact of PI-RADS v2 on indication of prostate biopsy

Cited by 11 publications

References 30 publications

What to expect from a non-suspicious prostate MRI? A review

What to expect from a non-suspicious prostate MRI? A review

Correlation between prostate imaging reporting and data system version 2, prostate-specific antigen levels, and local staging in biopsy-proven carcinoma prostate: A retrospective study

New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study

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