3T multiparametric MR imaging, PIRADSv2-based detection of index prostate cancer lesions in the transition zone and the peripheral zone using whole mount histopathology as reference standard

Asvadi, Nazanin H.; Mirak, Sohrab Afshari; Bajgiran, Amirhossein Mohammadian; Khoshnoodi, Pooria; Wibulpolprasert, Pornphan; Margolis, Daniel; Sisk, Anthony; Reiter, Robert E.; Raman, Steven S.

doi:10.1007/s00261-018-1598-9

Cited by 16 publications

(18 citation statements)

References 13 publications

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“…The results of some studies that compared mpMRI to whole-mount section analysis is shown in Table 2. While sensitivity differs substantially within the cohorts reported here (sensitivities ranging from 74.3% to 100%), an important finding is consistent in all of them, high sensitivity for csPC on a patient basis shows that mpMRI is a relatively reliable pretest before prostate biopsy [16,[27][28][29][30][31][32][33][34]. Equally important with the ongoing discussions on overdetection and overtreatment of PC is the limited sensitivity for low grade PC.…”

Section: The Pre-biopsy Settingsupporting

confidence: 77%

“…While this adoption is supported by the high detection rate of MRI-TB and SB, sensitivity on a lesion basis is not comparably high. In recent studies, detection rates on a lesion basis for any PC and csPC vary between 39% to 59% and 56% to 88%, respectively [ 16 27 28 29 30 31 32 33 34 ]. A summary of studies on this issue can be found in Table 2 .…”

Section: Main Bodymentioning

confidence: 99%

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Role of Multiparametric Magnetic Resonance Imaging in Predicting Pathologic Outcomes in Prostate Cancer

Harland

Stenzl

Todenhöfer

2021

World J Mens Health

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For a long time, the urological community has been on a quest to find the best means for early detection of prostate cancer (PC). An important milestone was the introduction of prostate-specific antigen (PSA)-testing. While initial results regarding a structured screening were controversial, with longer follow-up of the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial [1] and more detailed assessment of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) trial [2,3] the advantage is increasingly evident, with the number needed to screen dropping below the levels of the widely accepted breast cancer screening [4]. A variety of markers have since been introduced with improved "sensitivity" and specificity, but low availability and high cost have prevented their wide

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Section: The Pre-biopsy Settingsupporting

confidence: 77%

Section: Main Bodymentioning

confidence: 99%

Role of Multiparametric Magnetic Resonance Imaging in Predicting Pathologic Outcomes in Prostate Cancer

Harland

Stenzl

Todenhöfer

2021

World J Mens Health

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“…PI‐RADS category 3–5 lesions in the PZ had a higher csPCa rate (26.7% to 90.9%, respectively), which indicates that targeting should be considered high‐yield for PI‐RADS category ≥3 in the PZ, and low‐yield for PI‐RADS category 2 or 3 lesions in the TZ/CZ located in the middle or base of the prostate, which is in line with the previous studies. In the examination of whole prostate gland specimens, it was reported that approximately 30% of PCa was located in the TZ, and just 20% was located in the base of the prostate . PCa in the TZ was also of a lower cancer grade or lower pathological stage than that in the PZ .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

et al. 2019

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Objective To assess the clinical benefits of magnetic resonance imaging/transrectal ultrasound fusion‐targeted biopsy for biopsy‐naïve Japanese men. Methods Between February 2017 and August 2018, 131 biopsy‐naïve men who underwent targeted biopsy together with 10‐core systematic biopsy at Hiroshima University Hospital were retrospectively investigated. Multiparametric magnetic resonance imaging findings were reported based on Prostate Imaging Reporting and Data System version 2. Results The overall cancer detection rates per patient were 69.5% in systematic biopsy + targeted biopsy cores, 61.1% in systematic biopsy cores and 61.1% in targeted biopsy cores. The detection rates for clinically significant prostate cancer were 43.5% in targeted biopsy cores and 35.9% in systematic biopsy cores (P = 0.04), whereas the detection rates for clinically insignificant prostate cancer were 17.6% and 25.2% respectively (P = 0.04). Lesions in the peripheral zone were diagnosed more with clinically significant prostate cancer (54.8% vs 20.7%, P < 0.001) and International Society of Urological Pathology grade (3.2 vs 2.7, P = 0.02) than that in the inner gland. Just 4.2% (3/71) of Prostate Imaging Reporting and Data System category 2 and 3 lesions in the middle or base of the inner gland were found to have clinically significant prostate cancer. The cancer detection rate per core was 42.3% in targeted biopsy cores, whereas it was 17.9% in systematic biopsy cores (P < 0.001). Conclusions Targeted biopsy is able to improve the diagnostic accuracy of biopsy in detection of clinically significant prostate cancer by reducing the number of clinically insignificant prostate cancer detections compared with 10‐core systematic biopsy in biopsy‐naïve Japanese men. In addition, the present findings suggest that patients with Prostate Imaging Reporting and Data System category 2 or 3 lesions at the middle or base of the inner gland might avoid biopsies.

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“…However, a more effective way for clinicians to learn one disease is to learn a different yet similar disease analogically. The imaging manifestation of PTZC is similar to prostate peripheral zone cancer (PPZC) in some ways, and there are far more images of PPZC available [ 16 ]. Consequently, to deal with the scarcity of PTZC images and better differentiate them from BPH, we decided to imitate the human brain's analogical learning ability by combining TL and DCNN.…”

Section: Introductionmentioning

confidence: 99%

Classification of Prostate Transitional Zone Cancer and Hyperplasia Using Deep Transfer Learning From Disease-Related Images

Hu¹,

Yan²,

Yang³

et al. 2021

Cureus

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The diagnosis of prostate transition zone cancer (PTZC) remains a clinical challenge due to their similarity to benign prostatic hyperplasia (BPH) on MRI. The Deep Convolutional Neural Networks (DCNNs) showed high efficacy in diagnosing PTZC on medical imaging but was limited by the small data size. A transfer learning (TL) method was combined with deep learning to overcome this challenge. Materials and methodsA retrospective investigation was conducted on 217 patients enrolled from our hospital database (208 patients) and The Cancer Imaging Archive (nine patients). Using T2-weighted images (T2WIs) and apparent diffusion coefficient (ADC) maps, DCNN models were trained and compared between different TL databases (ImageNet vs. disease-related images) and protocols (from scratch, fine-tuning, or transductive transferring). ResultsPTZC and BPH can be classified through traditional DCNN. The efficacy of TL from natural images was limited but improved by transferring knowledge from the disease-related images. Furthermore, transductive TL from disease-related images had comparable efficacy to the fine-tuning method. Limitations include retrospective design and a relatively small sample size. ConclusionDeep TL from disease-related images is a powerful tool for an automated PTZC diagnostic system. In developing regions where only conventional MR scans are available, the accurate diagnosis of PTZC can be achieved via transductive deep TL from disease-related images.

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3T multiparametric MR imaging, PIRADSv2-based detection of index prostate cancer lesions in the transition zone and the peripheral zone using whole mount histopathology as reference standard

Abstract: The diagnostic performance of PI-RADSv2 for clinically significant transition and peripheral zone prostate cancer was similar. However, there was a lower portion of PI-RADSv2 4 and 5 lesions in transition zone compared to peripheral zone.

Cited by 16 publications

References 13 publications

Role of Multiparametric Magnetic Resonance Imaging in Predicting Pathologic Outcomes in Prostate Cancer

Role of Multiparametric Magnetic Resonance Imaging in Predicting Pathologic Outcomes in Prostate Cancer

Magnetic resonance imaging/transrectal ultrasonography fusion targeted prostate biopsy finds more significant prostate cancer in biopsy‐naïve Japanese men compared with the standard biopsy

Classification of Prostate Transitional Zone Cancer and Hyperplasia Using Deep Transfer Learning From Disease-Related Images

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