The diagnostic accuracy of multiparametric magnetic resonance imaging before biopsy in the detection of prostate cancer

Otti, Vanessa; Miller, Catherine L.; Powell, Roy; Thomas, Richard M.; McGrath, John

doi:10.1111/bju.14420

Cited by 29 publications

(51 citation statements)

References 31 publications

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“…Conversely, PSA density (PSAd) <0.15ng/ml/ml was found to be a significant predictive factor in 8 studies [7][8][9]11,19,22,34,35]. The NPV of the combination of mpMRI and PSAd <0.15ng/ml/ml ranged from 84% to 100% in these studies.…”

Section: Clinical Factors and Psa Densitymentioning

confidence: 78%

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What to expect from a non-suspicious prostate MRI? A review

Fiard

Norris

Nguyen

et al. 2020

Progrès en Urologie

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Abbreviations mpMRI Multiparametric Magnetic Resonance Imaging NPV Negative Predictive Value Résumé Contexte : La réalisation d'une IRM multiparamétrique (IRMmp) est désormais recommandée avant la réalisation de biopsies prostatiques. En revanche, la conduite à tenir en présence d'une IRMmp non-suspecte (Score Likert ou PIRADS 1-2) est toujours débattue. Objectifs : Faire une synthèse de la littérature récente pour répondre à trois questions. 1) Faut-il réaliser des biopsies systématisées en présence d'une IRMmp non suspecte ? 2) Quels facteurs prédictifs permettent de définir les patients candidats à une biopsie systématisée ? 3) Le manque de visibilité de certains cancers peut-elle être expliquée et quelles en sont les conséquences cliniques ? Sources : Une revue narrative de la littérature a été réalisée à partir des bases de données Medline utilisant deux recherches avec les termes "MRI" AND "prostate cancer" AND ("diagnosis" OR "biopsy") AND ("non-suspicious" OR "negative" OR "invisible") ; "prostate cancer MRI visible". Les références des articles sélectionnés ont été analysées à la recherche d'articles supplémentaires. Sélection des études : Les études publiées dans les 5 dernières années en anglais ont été analysées et retenues si les données disponibles permettaient de répondre à l'une des 3 questions posées. Résultats : Considérant les cancers de grade ISUP ³ 2 cliniquement significatifs, la valeur prédictive négative (VPN) de l'IRMmp était comprise entre 76% et 99%, dépendante de la prévalence du cancer et du type de test de référence utilisé. La VPN était plus élevée chez les patients aux antécédents de biopsie négative (88-96%), et plus faible chez les patients en surveillance active (85-90%). La densité de PSA (PSAd) avec un seuil de PSAd<0.15ng/ml/ml était le facteur prédictif le plus étudié et le plus pertinent associé à l'IRMmp pour éliminer un cancer significatif. Enfin, les tumeurs non visibles à l'IRMmp présentaient des différences au niveau histopathologique et génétique, conférant un intérêt clinique à la visibilité IRM. Limites du travail : La plupart des données proviennent de centres experts et les résultats peuvent ne pas être reproductibles en dehors. Conclusion : L'IRMmp fait preuve de performances diagnostiques élevées pour éliminer un cancer cliniquement significatif. La densité de PSA peut être utilisée pour sélectionner patients devant avoir une biopsie. Une meilleure connaissance des mécanismes à l'origine de la visibilité du cancer devrait aider le développement de nomogrammes et biomarqueurs plus précis.

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Section: Clinical Factors and Psa Densitymentioning

confidence: 78%

“…Similarly, the NPV of 85% demonstrated by Otti and colleagues accounts for the fact that transperineal biopsies (10 cores) were taken to sample anterior regions only, otherwise, transrectal sextant biopsies were performed [9].…”

Section: Biopsy-naïve Patientsmentioning

confidence: 94%

What to expect from a non-suspicious prostate MRI? A review

Fiard

Norris

Nguyen

et al. 2020

Progrès en Urologie

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“…The use of mpMRI to guide biopsies, as a first line diagnostic tool (rather than as second line when PB fails to detect lesions) is increasing, as it is its use to determine the need of prostatic biopsy in some individuals (16). Nevertheless, a normal mpMRI does not exclude the presence of PCa because mpMRI can detect lesions with high Gleason score and miss lesions with lower Gleason and areas deemed non-suspicious can still reveal significant disease with PB (2,4,12,17,18). Correlation between mpMRI identified lesions and radical prostatectomy was found to be accurate in lesions equal or superior to 0.2 ml, validating its use for fusion biopsy and possibly guided therapy (12,17,(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Lesion location agreement between prostatic multiparametric magnetic resonance, cognitive fusion biopsy and radical prostatectomy piece

Lourenço

Pissarra

Brito

et al. 2020

Arch Ital Urol Androl

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Introduction: Prostatic multiparametric magnetic resonance (mpMRI) allows for guided prostate biopsy (PB).Objective: To evaluate localization agreement between mpMRI lesions and histology obtained by cognitive PB and radical prostatectomy (RP) surgical specimen (SS). Methods: Out of 115 consecutive cognitive biopsied patients, 37 with positive PB were studied. Sample was characterized regarding age, prostatic volume, PI-RADS, location of lesion on mpMRI, lesion dimension, total number of fragments obtain by PB, number of fragments directed to the lesion, number of fragments with prostatic adenocarcinoma (PCa) and ISUP classification. The relationship between mpMRI and SS piece was analysed in 15 patients who underwent RP. Results: Regarding agreement between mpMRI and PB, agreement of location was observed in 26 (70.3%); 7 (18.9%) presented PCa positive fragments in the suspected zone plus others in the same lobe; 3 (8.1%) in the suspected zone plus the contralateral lobe and 1 (2.7%) had no PCa in the suspected zone but had bilateral PCa. The total number of fragments with PCa was lower in cases with agreement between mpMRI and PB (p < 0.05). Regarding agreement between mpMRI and SS, 5 cases (33.3%) presented the same location as described by mpMRI, 5 (33.3%) showed ipsilateral lesions in other zones of the prostate; 4 (26.7%) presented extensive bilateral lesions on all prostate zones and 1 (6.7%) showed previously unknown contralateral lesions. None of the factors studied related mpMRI and RP (p > 0.05). Conclusions: Localization agreement of mpMRI vs PB and mpMRI vs SS was present in 26/37 (70.3%) and 5/15 (33.3%), respectively. That suggests the existence of other lesions (multifocality) not identified on mpMRI.

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“…PI-RADS v2 was published in 2015, introducing the concept of "dominant sequences" to simplify mpMRI evaluation, and updated the 27-sector map to a 39-sector map, separating the central zone of the prostate. 10 The diagnostic accuracy of mpMRI has been investigated against histopathological specimens obtained by transperineal or transrectal ultrasound-guided (TRUS) biopsy, [11][12][13] template mapping prostate biopsy (TMPB) 14,15 and/or radical prostatectomy (RP). [16][17][18][19][20] While each technique for histopathological sampling has its own limitations, 21 RP is often considered the "gold standard," as it provides a definitive evaluation of the prostate gland.…”

Section: Introductionmentioning

confidence: 99%

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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The diagnostic accuracy of multiparametric magnetic resonance imaging before biopsy in the detection of prostate cancer

Abstract: In a routine clinical setting, the higher the mpMRI PI-RADS, the greater the detection rate of csPCa in biopsy-naïve men. A normal mpMRI does not exclude csPCa; however, mpMRI may have utility in informing shared-decision making on whether to proceed to biopsy and subsequent treatment.

Cited by 29 publications

References 31 publications

What to expect from a non-suspicious prostate MRI? A review

What to expect from a non-suspicious prostate MRI? A review

Lesion location agreement between prostatic multiparametric magnetic resonance, cognitive fusion biopsy and radical prostatectomy piece

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

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