Areas suspicious for prostate cancer: MR-guided biopsy in patients with at least one transrectal US-guided biopsy with a negative finding-multiparametric MR imaging for detection and biopsy planning

Abstract

Radiology. 2011;259:162-72 Purpose: To prospectively investigate the incremental value of multiparametric magnetic resonance (MR) imaging compared with standard T2-weighted imaging for biopsy planning. Materials and Methods: The study was approved by the institutional review board; informed consent was obtained. Consecutive patients underwent T2-weighted imaging supplemented with multiparametric 1.5-T MR imaging, consisting of hydrogen 1 ((1)H) MR spectroscopy, diffusion-weighted (DW) imaging, and contrast material-enhanced MR imaging. Quantitative parameters were calculated: (choline plus creatine)-to-citrate ratio, apparent diffusion coefficient, and volume transfer constant and exchange rate constant. The prostate was divided into 20 standardized areas. Each area was classified as benign, inconclusive, or suspicious at T2-weighted imaging, followed by quantitative evaluation of all inconclusive and suspicious areas with multiparametric MR imaging. MR-guided biopsy was performed in lesions classified as suspicious for cancer with at least one of the techniques after transfer to three-dimensional T2-weighted images. Diagnostic parameters were calculated on a per-lesion and per-patient basis for all combinations of T2-weighted imaging with multiparametric MR imaging.

Supporting prostate cancer focal therapy: a multidisciplinary International Consensus of Experts (“ICE”)

“…Multiparametric MR target biopsy to suspicious areas could improve the detection of significant or aggressive cancers and the assessment of tumor grade and volume [29][30][31][32]. Also, the MR target biopsy detection rate is good either for anterior and posterior cancers [31][32][33][34][35].…”

Prostate Cancer

“…After these exclusions, a total of 5 studies remained that fulfilled all inclusion criteria and were thus used in the meta-analysis. [15][16][17][18][19] Summary of Included Studies…”

“…Three studies originated from Asia, 15,16,18 2 originated from Europe, 17,19 and none from North America. Although 2 of the studies are from the same institution, 15,18 the patient cohorts in these 2 studies do not overlap.…”

“…For 1 study with somewhat higher sensitivity and substantially lower specificity than the other 4 studies for both DWI and DCE, these differences compared with the other studies were determined to be due to a difference in diagnostic threshold. 19 Given the presence of a threshold effect, heterogeneity was reassessed after exclusion of this study. After exclusion of this study, there continued to be statistically significant heterogeneity in terms of sensitivity for DWI and DCE (P < 0.001), as well as high heterogeneity based on I 2 (91.4%-92.5%).…”

Assessing the validity of Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) scoring system in diagnosis of peripheral zone prostate cancer

“…Franiel et al [17] proved that multi-parametric MRI using combined T2WI with functional imaging (DWI, spectroscopy, and DECI) techniques could detect all prostate cancers cases, but, the combination of DW imaging with MR spectroscopy or contrast-enhanced MR imaging failed to detect 6% of cancerous areas. Their detection rates and test negative results, respectively, were as following: T2-weighted imaging, 70% and 50%; T2-weighted imaging and 1H MR spectroscopy, 81% and 32%; T2-weighted imaging and contrast-enhanced MR imaging, 83% and 29%; T2-weighted imaging and DW imaging, 85% and 30%; T2-weighted imaging, 1H MR spectroscopy, and contrast-enhanced MR imaging, 91% and 13%; T2-weighted imaging, 1H MR spectroscopy, and DW imaging, 94% and 15%; T2-weighted imaging, DW imaging, and contrast-enhanced MR imaging, 94% and 13%; T2-weighted imaging, 1H MR spectroscopy, DW imaging, and contrast-enhanced MR imaging, 100% and 0%.…”