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

Huebner, Nicolai; Korn, Stephan; Resch, Irene; Grubmüller, Bernhard; Gross, Tobias; Gale, Robert Peter; Kramer, Gero; Poetsch, Nina; Clauser, Paola; Haitel, Andrea; Fajković, Harun; Shariat, Shahrokh F.; Baltzer, Pascal

doi:10.1007/s00330-020-07494-1

Cited by 12 publications

(11 citation statements)

References 32 publications

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“…Conversely, we observed lower interobserver agreement of a-bpMRI compared to previous reports [ 11 , 36 ]. One possible explanation is that T2WI, DWI, and DCE have an incremental value on lesion visibility, and the absence of multiplanar T2WI and ADC maps from our a-bpMRI protocol may have decreased the confidence of readers in determining MRI scores [ 37 ]. Furthermore, the use of Likert instead of PI-RADS for a-bpMRI could have played a role ( Supplementary Table S5 ) [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

et al. 2022

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(1) Background: There is currently limited evidence on the diagnostic accuracy of abbreviated biparametric MRI (a-bpMRI) protocols for prostate cancer (PCa) detection and screening. In the present study, we aim to investigate the performance of a-bpMRI among multiple readers and its potential application to an imaging-based screening setting. (2) Methods: A total of 151 men who underwent 3T multiparametric MRI (mpMRI) of the prostate and transperineal template prostate mapping biopsies were retrospectively selected. Corresponding bpMRI (multiplanar T2WI, DWI, ADC maps) and a-bpMRI (axial T2WI and b 2000 s/mm2 DWI only) dataset were derived from mpMRI. Three experienced radiologists scored a-bpMRI, standard biparametric MRI (bpMRI) and mpMRI in separate sessions. Diagnostic accuracy and interreader agreement of a-bpMRI was tested for different positivity thresholds and compared to bpMRI and mpMRI. Predictive values of a-bpMRI were computed for lower levels of PCa prevalence to simulate a screening setting. The primary definition of clinically significant PCa (csPCa) was Gleason ≥ 4 + 3, or cancer core length ≥ 6 mm. (3) Results: The median age was 62 years, the median PSA was 6.8 ng/mL, and the csPCa prevalence was 40%. Using a cut off of MRI score ≥ 3, the sensitivity and specificity of a-bpMRI were 92% and 48%, respectively. There was no significant difference in sensitivity compared to bpMRI and mpMRI. Interreader agreement of a-bpMRI was moderate (AC1 0.58). For a low prevalence of csPCa (e.g., <10%), higher cut offs (MRI score ≥ 4) yield a more favourable balance between the predictive values and positivity rate of MRI. (4) Conclusion: Abbreviated bpMRI protocols could match the diagnostic accuracy of bpMRI and mpMRI for the detection of csPCa. If a-bpMRI is used in low-prevalence settings, higher cut-offs for MRI positivity should be prioritised.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

et al. 2022

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“…Patients underwent mpMRI for further work-up of elevated serum PSA values or because of a suspicious digital rectal examination. All patients underwent MRI-TRUS biopsy, as described previously [18], specifically targeting the mpMRI detected lesion, as well as systematic prostate sampling. Lesions suspicious on routine mpMRI assessment were recalled and marked prior to biopsy by an expert genitourinary radiologist (16 years of experience, >1500 scans per year [9]) using the DynaCAD Software (Invivo, PHILIPS).…”

Section: Patientsmentioning

confidence: 99%

Impact of PI-QUAL on PI-RADS and cancer yield in an MRI-TRUS fusion biopsy population

Pötsch

Rainer

Clauser

et al. 2022

European Journal of Radiology

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“…[10][11][12] Therefore, the value of DCE-MRI as a routine sequence has been debated. 10,[13][14][15][16][17] Prompt intervention is needed for clinically significant prostate cancer (Gleason score ≥ 3 + 4), which usually has poor differentiation, a damaged gland structure, a high degree of malignancy, and strong invasiveness. 9 This study used three sequence combinations (T2WI + DWI, T2WI + DCE, and T2WI + DWI + DCE) to analyse the diagnostic value of DCE-MRI for detecting tzPCa and clinically significant transitional-zone prostate cancer (cs-tzPCa) in PI-RADS Version 2.1, using transperineal ultrasound-guided prostate biopsy as the reference standard.…”

Section: Introductionmentioning

confidence: 99%

“… 10 , 11 , 12 Therefore, the value of DCE-MRI as a routine sequence has been debated. 10 , 13 , 14 , 15 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Effects of dynamic contrast enhancement on transition zone prostate cancer in Prostate Imaging Reporting and Data System Version 2.1

Zhang

et al. 2023

Radiology and Oncology

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Background The aim of the study was to analyse the effects of dynamic contrast enhanced (DCE)-MRI on transitional-zone prostate cancer (tzPCa) and clinically significant transitional-zone prostate cancer (cs-tzPCa) in Prostate Imaging Reporting and Data System (PI-RADS) Version 2.1. Patients and methods The diagnostic efficiencies of T2-weighted imaging (T2WI) + diffusion-weighted imaging (DWI), T2WI + dynamic contrast-enhancement (DCE), and T2WI + DWI + DCE in tzPCa and cs-tzPCa were compared using the score of ≥ 4 as the positive threshold and prostate biopsy as the reference standard. Results A total of 425 prostate cases were included in the study: 203 cases in the tzPCa group, and 146 in the cs-tzPCa group. The three sequence combinations had the similar areas under the curves in diagnosing tzPCa and cs-tzPCa (all P < 0.05). The sensitivity of T2WI + DCE and T2WI + DWI + DCE (84.7% and 85.7% for tzPCa; 88.4% and 89.7% for cs-tzPCa, respectively) in diagnosing tzPCa and cs-tzPCa was significantly greater than that of T2WI + DWI (79.3% for tzPCa; 82.9% for cs-tzPCa). The specificity of T2WI + DWI (86.5% for tzPCa; 74.9% for cs-tzPCa) were significantly greater than those of T2WI + DCE and T2WI + DWI + DCE (68.0% and 68.5% for tzPCa; 59.1% and 59.5% for cs-tzPCa, respectively) (all P > 0.05). The diagnostic efficacies of T2WI + DCE and T2WI + DWI + DCE had no significant differences (all P < 0.05). Conclusions DCE can improve the sensitivity of diagnosis for tzPCa and cs-tzPCa, and it is useful for small PCa lesion diagnosis.

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

Cited by 12 publications

References 32 publications

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

Impact of PI-QUAL on PI-RADS and cancer yield in an MRI-TRUS fusion biopsy population

Effects of dynamic contrast enhancement on transition zone prostate cancer in Prostate Imaging Reporting and Data System Version 2.1

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