Influence of the Location and Zone of Tumor in Prostate Cancer Detection and Localization on 3-T Multiparametric MRI Based on PI-RADS Version 2

Wibulpolprasert, Pornphan; Raman, Steven S.; Hsu, William; Margolis, Daniel; Asvadi, Nazanin H.; Khoshnoodi, Pooria; Moshksar, Amin; Tan, Nelly; Ahuja, Preeti; Maehara, Cleo K.; Sisk, Anthony; Sayre, James W.; Lu, David; Reiter, Robert E.

doi:10.2214/ajr.19.21608

Cited by 22 publications

(16 citation statements)

References 28 publications

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“…In our exploratory regression analysis, we found visibility on T2w sequence to be negatively impacted if the lesion was located in the TZ. Generally, the sensitivity of prostate MRI is worse in the TZ, as recently shown in a large study by Wibulpolprasert et al who found a sensitivity of 58.9% vs 51.2% (p < 0.001) in their adjusted per-sector analysis [29]. However, visibility in DWI or DCE did not depend on lesion location in our study.…”

Section: Discussionsupporting

confidence: 52%

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

et al. 2020

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Objectives To assess the visibility of clinically significant prostate cancer (PCA) lesions on the sequences multiparametric MRI of the prostate (mpMRI) and to evaluate whether the addition of dynamic contrast–enhanced imaging (DCE) improves the overall visibility. Methods We retrospectively evaluated multiparametric MRI images of 119 lesions in 111 patients with biopsy-proven clinically significant PCA. Three readers assigned visual grading scores for visibility on each sequence, and a visual grading characteristic analysis was performed. Linear regression was used to explore which factors contributed to visibility in individual sequences. Results The visibility of lesions was significantly better with mpMRI when compared to biparametric MRI in visual grading characteristic (VGC) analysis, with an AUCVGC of 0.62 (95% CI 0.55–0.69; p < 0.001). This benefit was seen across all readers. Multivariable linear regression revealed that a location in the peripheral zone was associated with better visibility on T2-weighted imaging (T2w). A higher Prostate Imaging-Reporting and Data System (PI-RADS) score was associated with better visibility on both diffusion-weighted imaging (DWI) and DCE. Increased lesion size was associated with better visibility on all sequences. Conclusions Visibility of clinically significant PCA is improved by using mpMRI. DCE and DWI images independently improve lesion visibility compared to T2w images alone. Further research into the potential of DCE to impact on clinical decision-making is suggested. Key Points • DCE and DWI images independently improve clinically significant prostate cancer lesion visibility compared to T2w images alone. • Multiparametric MRI (DCE, DWI, T2w) achieved significantly higher visibility scores than biparametric MRI (DWI, T2w). • Location in the transition zone is associated with poor visibility on T2w, while it did not affect visibility on DWI or DCE.

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Section: Discussionsupporting

confidence: 52%

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

et al. 2020

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“…In this study, for the detection of PCa, mpMRI had an overall sensitivity of 86% (CI, 82%-89%), and an overall specificity of 99% (CI, 98%-99%) when using 27 sectors and a 3T MRI unit. Wibulpolprasert et al 22 reported that mpMRI had an overall sensitivity of 28.5% and an overall specificity of 96.3%, when using 39 sectors and a 3T MRI, while Isebaert et al 30 Gleason ≥4+4. This corresponds with findings reported by Tan et al 32 and Lee et al, 33 who concluded that missed lesions on mpMRI were more likely to be lower grade PCa (Gleason 3 + 3 and 3 + 4).…”

Section: Discussionmentioning

confidence: 99%

“…17 Some studies investigating the accuracy of mpMRI against RP specimens described tumor location using prostate anatomical zones (peripheral or transitional), 19 anatomical "levels" (base, midgland and apex) 15 or PI-RADS sector maps. 22 To the authors' knowledge, however, no contemporary study reported the accuracy of 3T mpMRI with regards to the exact localization of tumors stratified using Dickinson's 27-sector map. This study, therefore, aimed to determine the diagnostic accuracy of 3T mpMRI for detecting and locating PCa (PI-RADS ≥ 3) on Dickinson's 27-sector map, using histopathology specimens from RP as the reference standard.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies investigating the accuracy of mpMRI against RP specimens described tumor location using prostate anatomical zones (peripheral or transitional), 19 anatomical “levels” (base, mid‐gland and apex) 15 or PI‐RADS sector maps 22 . To the authors’ knowledge, however, no contemporary study reported the accuracy of 3T mpMRI with regards to the exact localization of tumors stratified using Dickinson's 27‐sector map.…”

Section: Introductionmentioning

confidence: 99%

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The diagnostic accuracy of multiparametric MRI for detection and localization of prostate cancer depends on the affected region

Martins¹,

Regusci²,

Rohner³

et al. 2020

BJUI Compass

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“…However, the delicate chain that runs from clinical suspicion to diagnosis is prone to successive pitfalls such as false-positive MRI findings, PI-RADS inter-reader variability, influence of tumor location, and technical errors in image registration or needle placement [10][11][12]. Thus, discordance between MRI and fusion biopsies may result in inadequate risk stratification that may be redressed by softwareregistration IGBs.…”

Section: Introductionmentioning

confidence: 99%

Managing Discordant Findings Between Multiparametric Magnetic Resonance Imaging and Transrectal Magnetic Resonance Imaging–directed Prostate Biopsy—The Key Role of Magnetic Resonance Imaging–directed Transperineal Biopsy

Bajeot

Covin²,

Meyrignac

et al. 2022

European Urology Oncology

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Background: Discordant findings between multiparametric magnetic resonance imaging (mpMRI) and transrectal image-guided biopsies of the prostate (TRUS-P) may result in inadequate risk stratification of localized prostate cancer. Objective: To assess transperineal image-guided biopsies of the index target (TPER-IT) in terms of disease reclassification and treatment recommendations. Design, setting, and participants: Cases referred for suspicion or treatment of localized prostate cancer were reviewed in a multidisciplinary setting, and discordance was characterized into three scenarios: type I-negative biopsies or International Society of Urological Pathology (ISUP) grade 1 cancer in Prostate Imaging Reporting and Data System (PI-RADS) 4 index target (IT); type II-negative biopsies or ISUP grade 1 cancer in anterior IT; and type III-<3 mm stretch of cancer in PI-RADS 3 IT. Discordant findings were characterized in 132/558 (23.7%) patients after TRUS-P. Of these patients, 102 received reassessment TPER-IT. Outcome measurements and statistical analysis: The primary objective was to report changes in treatment recommendations after TPER-IT. Therefore, cores obtained by primary TRUS-P and TPER-IT were analyzed in terms of cancer detection, ISUP grade, and Cambridge Prognostic Group classification using descriptive statistics. Results and limitations: TPER-IT biopsies that consisted of fewer cores than the initial TRUS-P (seven vs 14, p < 0.0001) resulted in more cancer tissue materials for analysis (56 vs 42.5 mm, p = 0.0003). As a result, 40% of patients initially considered for follow-up (12/30) and 49% for active surveillance (30/61) were reassigned after TPER-IT to surgery or intensity-modulated radiotherapy.

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Influence of the Location and Zone of Tumor in Prostate Cancer Detection and Localization on 3-T Multiparametric MRI Based on PI-RADS Version 2

Cited by 22 publications

References 28 publications

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)—do we still need contrast media?

The diagnostic accuracy of multiparametric MRI for detection and localization of prostate cancer depends on the affected region

Managing Discordant Findings Between Multiparametric Magnetic Resonance Imaging and Transrectal Magnetic Resonance Imaging–directed Prostate Biopsy—The Key Role of Magnetic Resonance Imaging–directed Transperineal Biopsy

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