Dataset Information

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography-fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3-5.

ABSTRACT:

Objectives

To evaluate the detection rates of clinically significant prostate cancer classified according to the prostate imaging reporting and data system scoring system using magnetic resonance imaging/ultrasound rigid fusion targeted biopsy.

Methods

A total of 339 patients underwent transperineal magnetic resonance imaging/ultrasound rigid fusion targeted biopsy in our institution between January 2015 and July 2017. Patients with prostate imaging reporting and data system category 1 or 2 and those with a pre-biopsy prostate-specific antigen value of >30 ng/mL were excluded from this study. Finally, 310 patients were recruited.

Results

The detection rates of clinically significant prostate cancer with prostate imaging reporting and data system category 3, 4, and 5 were 1.0% (1/98), 35.1% (47/134) and 73.1% (57/78), respectively. The factors affecting the detection of clinically significant prostate cancer with prostate imaging reporting and data system categories 4 and 5 were: (i) prostate imaging reporting and data system category 5; (ii) prostate volume <40 cc; (iii) no previous biopsy; (iv) lesion located in the peripheral zone; and (v) prostate-specific antigen density >0.35 ng/mL/mL.

Conclusions

The detection rate of clinically significant prostate cancer on magnetic resonance imaging/ultrasound rigid fusion targeted biopsy is very low in patients with prostate imaging reporting and data system category 3; therefore, patients with this classification should not undergo targeted biopsy. Prostate-specific antigen density, prostate volume, locations of suspected cancer and history of biopsy should be considered to predict the detection rate of clinically significant prostate cancer with prostate imaging reporting and data system categories 4 and 5.

SUBMITTER: Hakozaki Y

PROVIDER: S-EPMC7379286 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography-fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3-5.

Hakozaki Yuji Y Matsushima Hisashi H Murata Taro T Masuda Tomoko T Hirai Yoko Y Oda Mai M Kawauchi Nobuo N Yokoyama Munehiro M Kume Haruki H

International journal of urology : official journal of the Japanese Urological Association 20181121 2

<h4>Objectives</h4>To evaluate the detection rates of clinically significant prostate cancer classified according to the prostate imaging reporting and data system scoring system using magnetic resonance imaging/ultrasound rigid fusion targeted biopsy.<h4>Methods</h4>A total of 339 patients underwent transperineal magnetic resonance imaging/ultrasound rigid fusion targeted biopsy in our institution between January 2015 and July 2017. Patients with prostate imaging reporting and data system categ ...[more]

PMID: 30461076

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Project description:BackgroundAmide proton transfer-weighted magnetic resonance imaging (APTw-MRI) and apparent diffusion coefficient (ADC) values can effectively differentiate clinically significant prostate cancer (csPCa). However, their added value in Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v. 2.1) remains uncertain. This study aimed to investigate the added value of APTw-MRI and ADC to PI-RADS v. 2.1 in differentiating csPCa.MethodsThis study included 161 participants who underwent prostate biopsy or radical prostatectomy within 1 month following MRI. Six magnetic resonance (MR) parameters [minimum APT value (APTmin), maximum APT value (APTmax), mean APT value (APTmean), minimum ADC value (ADCmin), maximum ADC value (ADCmax), and mean ADC value (ADCmean)] and the PI-RADS score were acquired by two radiologists. Receiver operating characteristic (ROC) curve analysis was performed to evaluate and select parameters with the greatest performance from the APT and ADC values. Multivariate logistic regression analysis was conducted to construct models based on selected MR parameters and the PI-RADS score. The Delong test was applied to compare the area under the ROC curve (AUC) between models.ResultsThe lesions of csPCa exhibited higher APT values and lower ADC values than not clinically significant prostate cancer (ncsPCa). The greatest comprehensive performance in differentiating csPCa was achieved by APTmean (AUC: 0.723; cutoff value: >1.644) and ADCmean (AUC: 0.759; cutoff value: <0.656). The addition of APTmean significantly improved the performance of the model based on the PI-RADS score (AUC: APT PI-RADS 0.867 vs. PI-RADS 0.813; P=0.002). The introduction of ADCmean further improved the performance of the model based on APTmean and PI-RADS (AUC: combined model 0.875 vs. PI-RADS 0.867, P=0.69), and it retained high diagnostic efficacy (AUC: 0.835) in the validation cohort. Further verification through calibration curve and decision curve analysis demonstrated that the adjusted PI-RADS model exhibited remarkable precision and practicality.ConclusionsAPTw-MRI and ADC are valuable parameters for differentiating csPCa and can provide additional value for improving the efficiency and clinical benefit of PI-RADS v. 2.1.

Project description:PurposeGiven the limitations of prostate specific antigen and standard biopsies for detecting prostate cancer, we evaluated the cancer detection rate and external validity of a magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy system used at the National Institutes of Health.Materials and methodsWe performed a phase III trial of a magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy system with participants enrolled between 2012 and 2013. A total of 153 men consented to the study and underwent 3 Tesla multiparametric magnetic resonance imaging with an endorectal coil for clinical suspicion of prostate cancer. Lesions were classified as low or moderate/high risk for prostate cancer. Magnetic resonance imaging/transrectal ultrasound fusion guided biopsy and standard 12-core prostate biopsy were performed and 105 men were eligible for analysis.ResultsMean patient age was 65.8 years and mean prostate specific antigen was 9.5 ng/ml. The overall cancer detection rate was 62.9% (66 of 105 patients). The cancer detection rate in those with moderate/high risk on imaging was 72.3% (47 of 65) vs 47.5% (19 of 40) in those classified as low risk for prostate cancer (p<0.05). Mean tumor core length was 4.6 and 3.7 mm for fusion biopsy and standard 12-core biopsy, respectively (p<0.05). Magnetic resonance imaging/transrectal ultrasound fusion guided biopsy detected prostate cancer that was missed by standard 12-core biopsy in 14.3% of cases (15 of 105), of which 86.7% (13 of 15) were clinically significant. This biopsy upgraded 23.5% of cancers (4 of 17) deemed clinically insignificant on 12-core biopsy to clinically significant prostate cancer necessitating treatment.ConclusionsMagnetic resonance imaging/transrectal ultrasound fusion guided biopsy can improve prostate cancer detection. The results of this trial support the external validity of this platform and may be the next step in the evolution of prostate cancer management.

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Dataset Information

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography-fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3-5.

Objectives

Methods

Results

Conclusions

Publications

Detection rate of clinically significant prostate cancer in magnetic resonance imaging and ultrasonography-fusion transperineal targeted biopsy for lesions with a prostate imaging reporting and data system version 2 score of 3-5.

Similar Datasets

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