Usefulness of Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer

Wu, Lian Ming; Xu, Jian; Gu, Hanyang; Chen, Jie; Zhang, Wei; Zhu, Jiong; Ye, Yongquan; Hu, Jiani

doi:10.1016/j.acra.2012.05.016

Cited by 33 publications

(26 citation statements)

References 39 publications

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“…Next, we focused on the SROC curve, which gave an AUC of 0.8991 indicating a good, but not excellent, diagnostic performance. This result was in accordance with previous studies [34, 35, 37, 38]. Moreover, owing to the larger number of original studies and extensive statistical analysis, results of this study make up for some limitations that previous studies acknowledged and gave objective and practical suggestions for.…”

Section: Discussionsupporting

confidence: 91%

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

2014

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ObjectivesTo evaluate the diagnostic performance of diffusion-weighted imaging (DWI) as a single non-invasive method in detecting prostate cancer (PCa) and to deduce its clinical utility.MethodsA systematic literature search was performed to identify relevant original studies. Quality of included studies was assessed by QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Data were extracted to calculate sensitivity and specificity as well as running the test of heterogeneity and threshold effect. The summary receiver operating characteristic (SROC) curve was drawn and area under SROC curve (AUC) served as a determination of the diagnostic performance of DWI for the detection of PCa.ResultsA total of 21 studies were included, with 27 subsets of data available for analysis. The pooled sensitivity and specificity with corresponding 95 % confidence interval (CI) were 0.62 (95 % CI 0.61–0.64) and 0.90 (95 % CI 0.89–0.90), respectively. Pooled positive likelihood ratio and negative likelihood ratio were 5.83 (95 % CI 4.61–7.37) and 0.30 (95 % CI 0.23–0.39), respectively. The AUC was 0.8991. Significant heterogeneity was observed. There was no notable publication bias.ConclusionsDWI is an informative MRI modality in detecting PCa and shows moderately high diagnostic accuracy. General clinical application was limited because of the absence of standardized DW-MRI techniques.Key points• DWI provides incremental information for the detection and evaluation of PCa• DWI has moderately high diagnostic accuracy in detecting PCa• Patient condition, imaging protocols and study design positively influence diagnostic performance• General clinical application requires optimization of image acquisition and interpretation

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Section: Discussionsupporting

confidence: 91%

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

2014

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“…[6][7][8][9] Clinical guidelines now advise performing mpMRI when the clinical suspicion on prostate cancer persists despite negative TRUS biopsy results. 10 There are several techniques available to utilize MRI information for direct targeted biopsies.…”

Section: Introductionmentioning

confidence: 99%

An Ex Vivo Phantom Validation Study of an MRI-Transrectal Ultrasound Fusion Device for Targeted Prostate Biopsy

Wegelin

Henken

Somford

et al. 2016

Journal of Endourology

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“…Despite high sensitivity and specificity for the detection of csPCa using mpMRI, [15][16][17][18] several limitations need to be discussed. In our study, Likert scores of 2 and 3 were associated with a 22.2% and 38% of Gleason score 7 or more, respectively.…”

Section: No Cancer Gleason 6 Gleason 3 + 4 Gleason 4 + 3 Gleason 8 Glmentioning

confidence: 99%

“…[11][12][13][14] Reviews and meta-analyses have demonstrated sensitivity and specificity between 70-90% for the detection of clinically significant prostate cancer (csPCa). [15][16][17][18] Thus, MRI is increasingly used in the PCa diagnostic pathway and may influence the decision of whether or not to perform a biopsy. The type of biopsy, performed either by transrectal or transperineal route, may be different using a mpMRI.…”

Section: Introductionmentioning

confidence: 99%

Transrectal ultrasound-guided biopsy for prostate cancer detection: Systematic and/or magnetic-resonance imaging-targeted

Bladou

Fogaing

Levental

et al. 2017

CUAJ

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Introduction: Magnetic resonance imaging (MRI) is being more widely used in the detection of prostate cancer (PCa), particularly after an initial negative biopsy. In this study, we compared 12-core systematic biopsy (SYS), MRI-targeted biopsy (TAR), and the association of systematic and MRI-targeted (SYS+TAR) prostate biopsy in patients with previous biopsy and those who were biopsy-naive to evaluate the differences in terms of cancer detection and clinically significant cancer detection between the three modalities. Methods: Overall, 203 consecutive patients with suspicion of PCa were analyzed; 48.2% were biopsy-naive and 51.7% had at least one previous negative prostate biopsy. The median age was 66 years, median prostate-specific antigen (PSA) level was 7.9 ng/mL and median prostate volume was 46 mL. 38.9% had SYS, 19.2% TAR only, and 41.8% had SYS+TAR biopsy. Results: Overall, the PCa detection (PCaDR) was 63%. The SYS+TAR biopsy detected significantly more cancer than SYS and TAR only biopsies (72.9% vs. 56.9% and 53.8% respectively; p=0.03). Detection rate of clinically significant cancer (csPCaDR) was 50.7% overall; 65.8% in the SYS+TAR biopsy vs. 39.2% in the SYS and 48.7% in the TAR groups (p=0.002). In the biopsy-naive group, PCaDR and csPCaDR were significantly higher in the SYS+TAR group than in the SYS and TAR groups (p=0.01). In the repeat biopsy group, PCaDR and csPCaDR were equivalent in the TAR and SYS+TAR groups and higher than in the SYS group (p=0.001). Conclusions: TAR biopsy, when added to SYS biopsy, was associated with a higher detection rate of csPCa in biopsy-naive patients when compared to TAR and SYS only biopsies. In patients after previous negative biopsy, detection rates of csPCa were equivalent for SYS+TAR and TAR only biopsies, but higher than SYS.

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Usefulness of Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Prostate Cancer

Cited by 33 publications

References 39 publications

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

An Ex Vivo Phantom Validation Study of an MRI-Transrectal Ultrasound Fusion Device for Targeted Prostate Biopsy

Transrectal ultrasound-guided biopsy for prostate cancer detection: Systematic and/or magnetic-resonance imaging-targeted

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