Multiparametric 3T Prostate Magnetic Resonance Imaging to Detect Cancer: Histopathological Correlation Using Prostatectomy Specimens Processed in Customized Magnetic Resonance Imaging Based Molds

Türkbey, Barış; Mani, Haresh; Shah, Vijay; Rastinehad, Ardeshir R.; Bernardo, Marcelino; Pohida, Thomas J.; Pang, Yuxi; Daar, Dagane; Benjamin, Compton J.; McKinney, Yolanda; Trivedi, Hari; Chua, Celene; Bratslavsky, Gennady; Shih, Joanna H.; Linehan, W. Marston; Merino, María J.; Choyke, Peter L.; Pinto, Peter A.

doi:10.1016/j.juro.2011.07.013

Cited by 431 publications

(340 citation statements)

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“…Indeed, even extended biopsy protocols can miss cancers with unfavorable features, leading to improper selection for AS (17). Multiparametric magnetic resonance (MR) imaging, including both anatomic and functional sequences, has been shown to be effective for the detection and local staging of prostate cancer (18); however, multiparametric MR imaging currently is not included in the decision-making algorithms or criteria for AS. The purpose of this study was to determine whether multiparametric MR imaging can help identify patients who would most appropriately be candidates for AS according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D'Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy.…”

Section: Genitourinary Imaging: Multiparametric Mr Imaging For Assignmentioning

confidence: 99%

“…An imaging score was assigned to each lesion on the basis of its features on images obtained with different pulse sequences at MR imaging, yielding low, moderate, and high suspicion levels (Table 3). For multiparametric MR imaging analysis, on T2-weighted MR images and apparent diffusion coefficient maps from DW MR imaging, the criterion for a "visible" lesion was a well circumscribed, round-ellipsoid, low-signal-intensity region within the prostate gland (18,19). The analysis of three-dimensional MR spectroscopy images evaluated choline (Cho)/citrate (Cit) ratios within voxels in the biopsy core sites.…”

Section: Multiparametric Mr Imagingmentioning

confidence: 99%

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Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

Türkbey

Mani²,

Aras³

et al. 2013

Radiology

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197

134

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Purpose:To determine whether multiparametric magnetic resonance (MR) imaging can help identify patients with prostate cancer who would most appropriately be candidates for active surveillance (AS) according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D'Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy. Materials and Methods:This institutional review board-approved HIPAA-compliant retrospectively designed study included 133 patients (mean age, 59.3 years) with a mean prostate-specific antigen level of 6.73 ng/mL (median, 4.39 ng/mL) who underwent multiparametric MR imaging at 3.0 T before radical prostatectomy. Informed consent was obtained from all patients. Patients were then retrospectively classified as to whether they would have met AS eligibility criteria or were better served by surgery. AS eligibility criteria for prostatectomy specimens were a dominant tumor smaller than 0.5 mL without Gleason 4 or 5 patterns or extracapsular or seminal vesicle invasion. Conventional clinical assessment scores (the D'Amico, Epstein, and CAPRA scoring systems) were compared with multiparametric MR imaging findings for predicting AS candidates. The level of significance of difference between scoring systems was determined by using the x 2 test for categoric variables with the level of significance set at P , .05. Results:Among 133 patients, 14 were eligible for AS on the basis of prostatectomy results. The sensitivity, positive predictive value (PPV), and overall accuracy, respectively, were 93%, 25%, and 70% for the D'Amico system, 64%, 45%, and 88% for the Epstein criteria, and 93%, 20%, and 59% for the CAPRA scoring system for predicting AS candidates (P , .005 for all, x 2 test), while multiparametric MR imaging had a sensitivity of 93%, a PPV of 57%, and an overall accuracy of 92% (P , .005). Conclusion:Multiparametric MR imaging provides useful additional information to existing clinicopathologic scoring systems of prostate cancer and improves the assignment of treatment (eg, AS or active treatment).q RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Genitourinary Imaging: Multiparametric Mr Imaging For Assignmentioning

confidence: 99%

Section: Multiparametric Mr Imagingmentioning

confidence: 99%

Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

Türkbey

Mani²,

Aras³

et al. 2013

Radiology

Self Cite

197

134

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“…MR spectroscopy was not performed because of its cost, extra imaging time, and relatively poor sensitivity. 9 Men who had suspicious lesion(s) on MP-MRI and were referred by their primary urologists for study evaluation were then consented and enrolled onto the trial. Exclusion criteria for these analyses included a previous history of CaP, radiation to the pelvis, and inability to tolerate prostate biopsy under local anesthesia or mild sedation.…”

Section: Methodsmentioning

confidence: 99%

“…7 Conversely, it has been demonstrated that magnetic resonance (MR) imaging (MRI) with subsequent MRI/ transrectal ultrasound (MRI/TRUS) fusion-guided biopsy of the prostate has a high level of sensitivity and a high positive predictive value for identifying CaP with a correlation to clinical significance. [8][9][10] In the current study, for the first time to our knowledge, we compared the performance of the PCPTHG and multiparametric-MRI (MP-MRI) in identifying men at risk of high-grade or clinically significant CaP for prostate biopsy.…”

Section: Introductionmentioning

confidence: 99%

Multiparametric magnetic resonance imaging outperforms the Prostate Cancer Prevention Trial risk calculator in predicting clinically significant prostate cancer

Salami

Vira

Türkbey

et al. 2014

Cancer

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BACKGROUND:The Prostate Cancer Prevention Trial risk calculator for high-grade (PCPTHG) prostate cancer (CaP) was developed to improve the detection of clinically significant CaP. In this study, the authors compared the performance of the PCPTHG against multiparametric magnetic resonance imaging (MP-MRI) in predicting men at risk of CaP. METHODS: Men with an abnormal prostatespecific antigen (PSA) level or digital rectal examination (DRE) and a suspicious lesion on a 3-Tesla MP-MRI were enrolled prospectively. Three radiologists reviewed and graded all lesions on a 5-point Likert scale. Biopsy of suspicious lesion(s) was performed using a proprietary MRI/transrectal ultrasound fusion-guided prostate biopsy system, after which 12-core biopsy was performed. A genitourinary pathologist reviewed all pathology slides. The performance of PCPTHG was compared with that of MP-MRI in predicting clinically significant CaP. RESULTS: Of 175 men who were eligible for analysis, 64.6% (113 of 175 men) were diagnosed with CaP, including 93 of 113 men (82.3%) who had clinically significant disease. Age, abnormal DRE, PSA, PSA density, prostate size, extraprostatic extension on MRI, apparent diffusion coefficient value, and MRI lesion size were identified as significant predictors of high-grade CaP (all P <.05). The area under the receiver operating characteristic curve of PCPTHG for predicting high-grade CaP was 0.676 (95% confidence interval [CI], 0.592-0.751). By using a risk cutoff of 15% for biopsy as, proposed previously for high-grade CaP, sensitivity was 96.4%, specificity was 7.6%, and the false-positive rate was 51.1%. In contrast, the area under the receiver operating characteristic curve of MP-MRI for high-grade CaP was 0.769 (95% CI, 0.703-0.834), and it was 0.812 (95% CI, 0.754-0.

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“…but can also be used to evaluate tumor volume [31,32]. The diagnostic accuracy of the morphological MRI examination can be increased by MR spectroscopy from 52 % to 75 % [10].…”

Section: Dynamic Contrast-enhanced (Dce) Mrimentioning

confidence: 99%

Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

Durmus

Baur

Hamm

2014

Fortschr Röntgenstr

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!Prostate cancer is the most common malignancy in men, but only about 10 % of patients die from that cancer. Recent studies suggest that not all patients benefit from a radical therapeutic approach. When prostate cancer is suspected, magnetic resonance imaging (MRI) can make an important contribution to cancer localization within the prostate. Many studies show that T2-weighted morphologic imaging should be supplemented by multiparametric MRI techniques including diffusion-weighted imaging, contrast-enhanced sequences, and MR spectroscopy. This approach detects aggressive prostate cancer with high sensitivity and specificity. The findings of multiparametric MRI additionally contribute information to the assessment of cancer aggressiveness. The use of these multiparametric MRI techniques will gain an increasing role in the clinical management of prostate cancer patients. They can help in establishing a definitive diagnosis with a minimum of invasiveness and may also contribute to optimal individualized treatment. This review article presents the different techniques of multiparametric MRI and discusses their contribution to the detection of prostate cancer. Moreover, this review outlines an objective approach to image interpretation and structured reporting of MRI findings using the PI-RADS criteria. The review concludes with an outline of approaches to prostate biopsy on the basis of MRI (transrectal ultrasound, direct MRI guidance of tissue sampling, and MRI-ultrasound fusion biopsy) and emerging future uses of MRI in the planning of focal treatment options and in the active surveillance of patients diagnosed with prostate cancer.Citation Format:

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Multiparametric 3T Prostate Magnetic Resonance Imaging to Detect Cancer: Histopathological Correlation Using Prostatectomy Specimens Processed in Customized Magnetic Resonance Imaging Based Molds

Cited by 431 publications

References 20 publications

Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?

Multiparametric magnetic resonance imaging outperforms the Prostate Cancer Prevention Trial risk calculator in predicting clinically significant prostate cancer

Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

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