In‐gantry <scp>MRI</scp> guided prostate biopsy diagnosis of prostatitis and its relationship with <scp>PIRADS</scp> V.2 based score

Jyoti, Rajeev; Jina, N. Hamesh; Haxhimolla, Hodo

doi:10.1111/1754-9485.12555

Cited by 16 publications

(20 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conversely, a man with only benign inflammatory histology in biopsies was erroneously scored as cancer by all but one radiologist. These cases aptly demonstrate the inability of prostate MRI to detect some 7% of the csPCas correctly, whereas it is well known that inflammatory changes may confound a reading by appearing suspicious in prostate MRI and is a common cause for false positives [4,22,23].…”

Section: Discussionmentioning

confidence: 95%

Expected impact of MRI-related interreader variability on ProScreen prostate cancer screening trial: a pre-trial validation study

et al. 2020

View full text Add to dashboard Cite

Background The aim of this study is to investigate the potential impact of prostate magnetic resonance imaging (MRI) -related interreader variability on a population-based randomized prostate cancer screening trial (ProScreen). Methods From January 2014 to January 2018, 100 men aged 50–63 years with clinical suspicion of prostate cancer (PCa) in Helsinki University Hospital underwent MRI. Nine radiologists individually reviewed the pseudonymized MRI scans of all 100 men in two ProScreen trial centers. All 100 men were biopsied according to a histological composite variable comprising radical prostatectomy histology (N = 38) or biopsy result within 1 year from the imaging (N = 62). Fleiss’ kappa (κ) was used to estimate the combined agreement between all individual radiologists. Sample data were subsequently extrapolated to 1000-men subgroups of the ProScreen cohort. Results Altogether 89% men of the 100-men sample were diagnosed with PCa within a median of 2.4 years of follow-up. Clinically significant PCa (csPCa) was identified in 76% men. For all PCa, mean sensitivity was 79% (SD ±10%, range 62–96%), and mean specificity 60% (SD ±22%, range 27–82%). For csPCa (Gleason Grade 2–5) MRI was equally sensitive (mean 82%, SD ±9%, range 67–97%) but less specific (mean 47%, SD ±20%, range 21–75%). Interreader agreement for any lesion was fair (κ 0.40) and for PI-RADS 4–5 lesions it was moderate (κ 0.60). Upon extrapolating these data, the average sensitivity and specificity to a screening positive subgroup of 1000 men from ProScreen with a 30% prevalence of csPCa, 639 would be biopsied. Of these, 244 men would be true positive, and 395 false positive. Moreover, 361 men would not be referred to biopsy and among these, 56 csPCas would be missed. The variation among the radiologists was broad as the least sensitive radiologist would have twice as many men biopsied and almost three times more men would undergo unnecessary biopsies. Although the most sensitive radiologist would miss only 2.6% of csPCa (false negatives), the least sensitive radiologist would miss every third. Conclusions Interreader agreement was fair to moderate. The role of MRI in the ongoing ProScreen trial is crucial and has a substantial impact on the screening process.

show abstract

Section: Discussionmentioning

confidence: 95%

Expected impact of MRI-related interreader variability on ProScreen prostate cancer screening trial: a pre-trial validation study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Unfortunately, false-positive lesions continue to plague the accuracy of prostate MRI. Jyoti and colleagues published their experience of in-gantry MRI biopsies from Australia (n=137) noting that PI-RADS 3 and 4 lesions with inflammation accounted for 97% of the false-positive lesions mainly in the transition zone (54%) [9].…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation is known to mimic prostate cancer lesions on MRI, for example, chronic prostatitis or nodules following bacillus Calmette–Guérin treatment [789]. However, it is unknown how commonly inflammation plays a role in MRI fusion ultrasound-guided (MRI-US) prostate needle biopsies.…”

Section: Introductionmentioning

confidence: 99%

Inflammation appears as high Prostate Imaging–Reporting and Data System scores on prostate magnetic resonance imaging (MRI) leading to false positive MRI fusion biopsy

Rourke¹,

Sunnapwar

Mais

et al. 2019

Investig Clin Urol

View full text Add to dashboard Cite

Purpose To investigate if inflammation as a potential cause of false-positive lesions from recent UroNav magnetic resonance imaging (MRI) fusion prostate biopsy patients. Materials and Methods We retrospectively identified 43 men with 61 MRI lesions noted on prostate MRI before MRI ultrasound-guided fusion prostate biopsy. Men underwent MRI with 3T Siemens TIM Trio MRI system (Siemens AG, Germany), and lesions were identified and marked in DynaCAD system (Invivo Corporation, USA) with subsequent biopsy with MRI fusion with UroNav. We obtained targeted and standard 12-core needle biopsies. We retrospectively reviewed pathology reports for inflammation. Results We noted a total of 43 (70.5%) false-positive lesions with 28 having no cancer on any cores, and 15 lesions with cancer noted on systematic biopsy but not in the target region. Of the men with cancer, 6 of the false positive lesions had inflammation in the location of the targeted region of interest (40.0%, 6/15). However, when we examine the 21/28 lesions with an identified lesion on MRI with no cancer in all cores, 54.5% had inflammation on prostate biopsy pathology (12/22, p=0.024). We noted the highest proportion of inflammation. Conclusions Inflammation can confound the interpretation of MRI by mimicking prostate cancer. We suggested focused efforts to differentiate inflammation and cancer on prostate MRI.

show abstract

“…However, PI-RADS 1 or 2 does not have significant cancer 100% even though this category is very unlikely or unlikely to have it [1][2][3]. Moreover, because various kinds of inflammation can mimic prostate cancer, significant cancer cannot be detected if target biopsy alone is performed [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5

Park

2020

Precis Future Med

View full text Add to dashboard Cite

Purpose: To assess the value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5 (PI-RADS 5). Methods: Between March 2014 and November 2018, 186 men had a PI-RADS 5 categorized as an index lesion on magnetic resonance imaging prior to transrectal ultrasound (TRUS)-guided biopsy. Of these patients, 135 (group I) underwent target biopsy alone because of good depiction. The remaining 51 (group II) underwent target and systematic biopsies because of poor depiction. Significant cancer detection rates (CDRs) were compared between the groups. Which type of biopsies contributed to detecting significant cancer was evaluated in the group II. Results: Significant CDRs of the target biopsy were 67.4% (91/135) in the group I and 47.1% (24/51) in the group II (P=0.0173). However, when systematic biopsy was added to target biopsy, the significant CDR of the group II increased to 52.9% (27/51) (P=0.0900). Of the 27 significant cancers missed by target biopsy in the group II, three were detected by systematic biopsy alone. Moreover, systematic biopsy detected higher Gleason scores in two cases than target biopsy. Conclusion: Systematic biopsy contributes to detecting additional significant cancers in men with PI-RADS 5 partially visible on TRUS.

show abstract

In‐gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score

Cited by 16 publications

References 11 publications

Expected impact of MRI-related interreader variability on ProScreen prostate cancer screening trial: a pre-trial validation study

Expected impact of MRI-related interreader variability on ProScreen prostate cancer screening trial: a pre-trial validation study

Inflammation appears as high Prostate Imaging–Reporting and Data System scores on prostate magnetic resonance imaging (MRI) leading to false positive MRI fusion biopsy

Value of systematic biopsy added to target biopsy for detecting significant cancer in men with Prostate Imaging and Reporting and Data System 5

Contact Info

Product

Resources

About