How Often is the Dynamic Contrast Enhanced Score Needed in PI-RADS Version 2?

Roh, Albert T.; Fan, Richard E.; Sonn, Geoffrey A.; Vasanawala, Shreyas S.; Ghanouni, Pejman; Loening, Andreas M.

doi:10.1067/j.cpradiol.2019.05.008

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…The limited contribution that DCE-MRI makes to PCa diagnosis in the majority of cases under PI-RADS guidelines has led many to question whether the additional costs (contrast agent, preparation, scan, and reporting time) are warranted [28][29][30][31]. Unfortunately, this small pilot study is not sufficient to provide indications for use in problematic areas such as differentiating benign hyperplasia from carcinoma in the transitional zone or prostatitis from carcinoma in the peripheral zone [32].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer

Clemente,

Selva,

Berks

et al. 2024

Diagnostics

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Tofts models have failed to produce reliable quantitative markers for prostate cancer. We examined the differences between prostate zones and lesion PI-RADS categories and grade group (GG) using regions of interest drawn in tumor and normal-appearing tissue for a two-compartment uptake (2CU) model (including plasma volume (vp), plasma flow (Fp), permeability surface area product (PS), plasma mean transit time (MTTp), capillary transit time (Tc), extraction fraction (E), and transfer constant (Ktrans)) and exponential (amplitude (A), arrival time (t0), and enhancement rate (α)), sigmoidal (amplitude (A0), center time relative to arrival time (A1 − T0), and slope (A2)), and empirical mathematical models, and time to peak (TTP) parameters fitted to high temporal resolution (1.695s) DCE-MRI data. In 25 patients with 35 PI-RADS category 3 or higher tumors, we found Fp and α differed between peripheral and transition zones. Parameters Fp, MTTp, Tc, E, α, A1 − T0, and A2 and TTP all showed associations with PI-RADS categories and with GG in the PZ when normal-appearing regions were included in the non-cancer GG. PS and Ktrans were not associated with any PI-RADS category or GG. This pilot study suggests early enhancement parameters derived from ultrafast DCE-MRI may become markers of prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer

Clemente,

Selva,

Berks

et al. 2024

Diagnostics

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“…BpMRI did not show significant differences in tumor detection rates and diagnostic accuracy 16 . Another study revealed that only 62 (16%) of 388 patients required a DCE sequence to score prostate lesions using PIRADS version 2 17 . Our study revealed that half of 62 patients were reported as PIRADS-4 with contrast-enhanced imaging.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Biparametric and Multiparametric Prostate Magnetic Resonance Imaging in Predicting Oncologic Outcomes After Radical Prostatectomy

EFILOGLU¹,

Gündüz²,

İplikçi³

et al. 2022

MMJ

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Objective: This study aimed to evaluate the difference in predicting the pathological stage of retropubic radical prostatectomy (RRP) and biochemical recurrence (BCR) in patients with Prostate Imaging Reporting and Data System (PIRADS) scores of 3 and 4 on biparametric prostate magnetic resonance imaging (bpMRI) compared to patients who upgraded from PIRADS 3 to PIRADS 4 based on the contrast-enhanced PIRADS version 2.1. Methods: This study evaluated 107 patients who underwent RRP and had preoperative multiparametric prostate magnetic resonance imaging (mpMRI) and were followed regularly. Group 1 included 31 patients evaluated as PIRADS 3 in both bpMRI and mpMRI, group 2 included 31 patients evaluated as PIRADS 3 in bpMRI and PIRADS 4 in mpMRI, and group 3 included 45 patients evaluated as PIRADS 4 without contrast. Comparisons were made between groups 1 and 2 and between groups 2 and 3. Results: No significant difference was found between the groups in terms of demographic data, preoperative or postoperative radiology, and pathology findings. Extraprostatic extension positivity and BCR were more common in group 2 compared to group 1 although not significant. Multivariate regression analysis was performed to determine the risk factors in predicting BCR, which revealed the positivity of seminal vesicle invasion and high pathological stage in the pathology report as significant factors. Prostate-specific antigen (PSA) and PSA density were higher in group 3 than in group 2, but without significance. Conclusions: This study revealed that mpMRI did not contribute in predicting BCR after RRP compared to bpMRI.

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“…Forty studies were considered to be possibly related to our meta-analysis, and the full-texts of the studies were read in detail. A total of 10 studies including 752 patients and 831 lesions were ultimately included in the present analysis (8,9,(21)(22)(23)(24)(25)(26)(27)(28) to calculate the diagnostic ability of DCE-MRI for csPCa, while five of the 10 studies were used to assess the capacity of DCE-MRI in diagnosing PCa (8,21,23,24,26). Because Druskin et al did not report the specific numbers of PIRADS 3 patients ( 21), we estimate the number of patients in this group (PIRADS 3) to be 213 based on the information given in the study.…”

Section: Literature Searchmentioning

confidence: 99%

Diagnostic Ability of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Prostate Cancer and Clinically Significant Prostate Cancer in Equivocal Lesions: A Systematic Review and Meta-Analysis

et al. 2021

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BackgroundDynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) now has been used to diagnose prostate cancer (PCa). Equivocal lesions are defined as PIRADS category 3 or a Likert scale of 1 to 5 category 3 lesions. Currently, there are no clear recommendations for the management of these lesions. This study aimed to estimate the diagnostic capacity of DCE-MRI for PCa and clinically significant prostate cancer (csPCa) in equivocal lesions.Materials and methodsTwo researchers searched PubMed, Embase and Web of Science to identify studies that met our subject. We searched for articles that mention the accuracy of the diagnosis of DCE-MRI for PCa or csPCa in equivocal lesions and used histopathological results as the reference standard. We used a tool (the Quality Assessment of Diagnostic Accuracy Studies-2 tool) to evaluate the quality of the studies that we screened out. Meta-regression was used to explore the reasons for heterogeneity in results.ResultsTen articles were eventually included in our study. The sensitivity, specificity and 95% confidence intervals (CI) for DCE-MRI in diagnosing csPCa were 0.67 (95% CI, 0.56–0.76), 0.58 (95% CI, 0.46–0.68). The sensitivity and specificity and 95% CI for DCE-MRI in diagnosing PCa were 0.57 (95% CI, 0.46–0.68), 0.58 (95% CI, 0.45–0.70). The areas under the curve (AUC) of DCE-MRI were 0.67 (95% CI, 0.63–0.71) and 0.60 (95% CI, 0.55–0.64) while diagnosing csPCa and PCa. Through meta-regression, we found that study design, magnetic field strength, the definition of csPCa, and the scoring system were the sources of heterogeneity.ConclusionThe results of our study indicate that the role of DCE-MRI in equivocal lesions may be limited.

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How Often is the Dynamic Contrast Enhanced Score Needed in PI-RADS Version 2?

Cited by 9 publications

References 24 publications

Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer

Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer

Comparison of Biparametric and Multiparametric Prostate Magnetic Resonance Imaging in Predicting Oncologic Outcomes After Radical Prostatectomy

Diagnostic Ability of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Prostate Cancer and Clinically Significant Prostate Cancer in Equivocal Lesions: A Systematic Review and Meta-Analysis

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