1
|
Cornud F, Lefevre A, Flam T, Dumonceau O, Galiano M, Soyer P, Camparo P, Barral M. MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study. Eur Radiol 2020; 30:4838-4846. [PMID: 32350662 DOI: 10.1007/s00330-020-06882-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/25/2020] [Accepted: 04/09/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To evaluate the ability of high-frequency (29 MHz) transrectal micro-ultrasound (microUS) as a second-look examination after biparametric MRI (bp-MRI) and to reidentify focal lesions seen on diagnostic MRI and to detect new ones METHODS: A total of 118 consecutive men (mean age, 66 ± 13 [SD] years; range, 49-93 years) with a mean prostate-specific antigen level of 11 ± 19 (SD) ng/mL (range, 2-200 ng/mL) and at least one focal lesion (MRI+) with a score > 2 on bp-MRI were included. Of these, 79/118 (66.9%) were biopsy-naïve and 102/118 (86.5%) had non-suspicious rectal examination. All patients had MRI-directed microUS-guided biopsy using a 29-MHz transducer. All lesions visible on micro-ultrasound (microUS+) were targeted without image fusion, which was only used for MRI+/microUS- lesions. Significant prostate cancer (sPCa) was defined by a Gleason score ≥ 7 or a maximum cancer core length > 3 mm. RESULTS A total of 144 focal prostatic lesions were analyzed, including 114 (114/144, 79.2%) MRI+/microUS+ lesions, 13 MRI+/microUS- lesions (13/144, 9%), and 17 MRI-/microUS+ lesions (17/144, 11.8%). Significant PCa was detected in 70 MRI+/microUS+ lesions (70/114, 61.4%), in no MRI+/microUS- lesion (0/13, 0%), and in 4 MRI-/microUS+ lesions (4/17, 23.5%). The sensitivity and specificity of microUS on a per-patient and a per-lesion basis were 100% (95% CI, 84.9-100%) and 22.8% (95% CI, 12.5-35.8%) and 100% (95% CI, 85.1-100%) and 22.6% (95% CI, 12.3-36.2%), respectively. CONCLUSION MicroUS, as a second-look examination, may show promise to localize targets detected on bp-MRI. KEY POINTS • Used as a second-look examination, microUS-guided biopsies have a 100% detection rate of sCa originating in the PZ or lower third of the TZ, without microUS-MRI image fusion. • MicroUS results may provide additional information about lesions visible on MRI. • MicroUS may provide the ability to detect small PZ lesions undetected by bp-MRI.
Collapse
Affiliation(s)
- François Cornud
- Department of Radiology, Clinique de l'Alma, Paris, France. .,Department of Radiology, Hôpital Cochin, Assistance Publique Hôpitaux Paris, AP-HP, Paris, France.
| | - Arnaud Lefevre
- Department of Radiology, Clinique de l'Alma, Paris, France
| | - Thierry Flam
- Department of Urology, Clinique St Jean de Dieu, Paris, France
| | | | - Marc Galiano
- Department of Urology, Clinique de l'Alma, Paris, France
| | - Philippe Soyer
- Department of Radiology, Hôpital Cochin, Assistance Publique Hôpitaux Paris, AP-HP, Paris, France.,Université de Paris Descartes Paris V, Paris, France
| | | | - Matthias Barral
- Department of Radiology, Hôpital Cochin, Assistance Publique Hôpitaux Paris, AP-HP, Paris, France
| |
Collapse
|
2
|
In-Bore Transrectal MRI–Guided Biopsy With Robotic Assistance in the Diagnosis of Prostate Cancer: An Analysis of 57 Patients. AJR Am J Roentgenol 2019; 213:W171-W179. [DOI: 10.2214/ajr.19.21145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
3
|
Rouviere O, Moldovan PC. The current role of prostate multiparametric magnetic resonance imaging. Asian J Urol 2018; 6:137-145. [PMID: 31061799 PMCID: PMC6488694 DOI: 10.1016/j.ajur.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 12/21/2022] Open
Abstract
Prostate multi-parametric magnetic resonance imaging (mpMRI) has shown excellent sensitivity for Gleason ≥7 cancers, especially when their volume is ≥0.5 mL. As a result, performing an mpMRI before prostate biopsy could improve the detection of clinically significant prostate cancer (csPCa) by adding targeted biopsies to systematic biopsies. Currently, there is a consensus that targeted biopsies improve the detection of csPCa in the repeat biopsy setting and at confirmatory biopsy in patients considering active surveillance. Several prospective multicentric controlled trials recently showed that targeted biopsy also improved csPCa detection in biopsy-naïve patients. The role of mpMRI and targeted biopsy during the follow-up of active surveillance remains unclear. Whether systematic biopsy could be omitted in case of negative mpMRI is also a matter of controversy. mpMRI did show excellent negative predictive values (NPV) in the literature, however, since NPV depends on the prevalence of the disease, negative mpMRI findings should be interpreted in the light of a priori risk for csPCa of the patient. Nomograms combining mpMRI findings and classical risk predictors (age, prostate-specific antigen density, digital rectal examination, etc.) will probably be developed in the future to decide whether a prostate biopsy should be obtained. mpMRI has a good specificity for detecting T3 stage cancers, but its sensitivity is low. It should therefore not be used routinely for staging purposes in low-risk patients. Nomograms combining mpMRI findings and other clinical and biochemical data will also probably be used in the future to better assess the risk of T3 stage disease.
Collapse
Affiliation(s)
- Olivier Rouviere
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France.,Université de Lyon, Lyon, France.,Université Lyon 1, faculté de médecine Lyon Est, Lyon, France
| | - Paul Cezar Moldovan
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France.,Université de Lyon, Lyon, France.,Université Lyon 1, faculté de médecine Lyon Est, Lyon, France
| |
Collapse
|
4
|
Cornud F, Bomers J, Futterer J, Ghai S, Reijnen J, Tempany C. MR imaging-guided prostate interventional imaging: Ready for a clinical use? Diagn Interv Imaging 2018; 99:743-753. [DOI: 10.1016/j.diii.2018.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/08/2018] [Indexed: 01/22/2023]
|
5
|
Rouvière O, Souchon R, Melodelima C. Pitfalls in interpreting positive and negative predictive values: Application to prostate multiparametric magnetic resonance imaging. Diagn Interv Imaging 2018; 99:515-518. [PMID: 30177449 DOI: 10.1016/j.diii.2018.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Affiliation(s)
- O Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard-Herriot, 69437 Lyon, France; Faculté de médecine Lyon Est, Université Lyon 1, 69003 Lyon, France; Inserm, U1032, LabTau, 69003 Lyon, France.
| | - R Souchon
- Faculté de médecine Lyon Est, Université Lyon 1, 69003 Lyon, France
| | - C Melodelima
- CNRS, UMR 5553, BP 53, 38041 Grenoble, France; Université Grenoble-Alpes, Laboratoire d'écologie Alpine, BP 53, 38041 Grenoble, France
| |
Collapse
|
6
|
Tavolaro S, Mozer P, Roupret M, Comperat E, Rozet F, Barret E, Drouin S, Vaessen C, Lucidarme O, Cussenot O, Boudghène F, Renard-Penna R. Transition zone and anterior stromal prostate cancers: Evaluation of discriminant location criteria using multiparametric fusion-guided biopsy. Diagn Interv Imaging 2018; 99:403-411. [DOI: 10.1016/j.diii.2018.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/03/2018] [Accepted: 01/18/2018] [Indexed: 01/12/2023]
|
7
|
Variability induced by the MR imager in dynamic contrast-enhanced imaging of the prostate. Diagn Interv Imaging 2018; 99:255-264. [DOI: 10.1016/j.diii.2017.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/03/2017] [Accepted: 12/07/2017] [Indexed: 12/22/2022]
|
8
|
Is it time for a magnetic resonance imaging-targeted only prostate biopsy strategy? Diagn Interv Imaging 2017; 98:661-662. [DOI: 10.1016/j.diii.2017.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
9
|
Garcia Bennett J, Vilanova JC, Gumà Padró J, Parada D, Conejero A. Evaluation of MR imaging-targeted biopsies of the prostate in biopsy-naïve patients. A single centre study. Diagn Interv Imaging 2017; 98:677-684. [PMID: 28739430 DOI: 10.1016/j.diii.2017.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/11/2017] [Accepted: 06/12/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE To evaluate the differences in prostate cancer detection rate and biopsy effectiveness between magnetic resonance imaging (MRI) target biopsy (TB) and transperineal standard biopsy (SB) in biopsy-naïve patients. MATERIAL AND METHODS Between October 2014 and April 2016, 60 men with a mean age of 64.1±6.7 (SD) years (range: 53-82 years) were prospectively enrolled. All patients underwent a prostate MRI study, evaluated by two radiologists, before undergoing the biopsy. A transperineal 12-core SB was carried out before TB, without the information from the MRI. The detection rate for all tumors and for clinically significant tumors (CS) was recorded. Sampling variables such as the proportion of cores positive for CS cancer (PCP-CS) and the maximum cancer core length (MCCL) were also calculated. The ability of MRI to predict the presence of a CS tumor at biopsy was studied using a sector analysis. Patients with negative biopsies were followed during a minimum of 12 months. RESULTS The detection rate for SB and TB was 53.3% (32/60) and 46.7% (28/60) respectively for all tumors (P=0.289) and 45% (27/60) in both techniques for CS tumors. TB obtained a larger PCP-CS (P<0.001) and MCCL (P=0.018). The sensitivity, specificity, positive predictive value, negative predictive value and cancer prevalence was 83.3%, 92.9%, 83.3%, 92.9% and 30% for peripheral zone sectors and 43.8%, 97.1%, 70.0%, 91.8% and 13,3% for transitional zone sectors. The proportion of patients that showed an increase of PSA faster than 0.75ng/mL/year after a negative biopsy was 26.1%. CONCLUSION Detection rate of prostate cancer did not show significant differences between a TB and a SB technique in biopsy-naïve patients. However, targeted prostate biopsies demonstrated a better sampling effectiveness thus reducing the cores needed to diagnose clinically significant tumors.
Collapse
Affiliation(s)
- J Garcia Bennett
- Department of Radiology, Hospital Universitari Sant Joan de Reus, Av. del Dr. Josep Laporte, 2, 43204 Reus, Spain.
| | - J C Vilanova
- Clínica Girona, Institut Catalan of Health-IDI, University of Girona, C. Lorenzana, 36, 17002 Girona, Spain
| | - J Gumà Padró
- Department of Oncology, Hospital Universitari Sant Joan de Reus, Av. del Dr. Josep Laporte, 2, 43204 Reus, Spain
| | - D Parada
- Department of Pathology, Hospital Universitari Sant Joan de Reus/IISPV/URV, Av. del Dr. Josep Laporte, 2, 43204 Reus, Spain
| | - A Conejero
- Department of Radiology, Hospital Universitari Sant Joan de Reus, Av. del Dr. Josep Laporte, 2, 43204 Reus, Spain
| |
Collapse
|
10
|
Marin L, Ezziane M, Comperat E, Mozer P, Cancel-Tassin G, Coté JF, Racoceanu D, Boudghene F, Lucidarme O, Cussenot O, Renard Penna R. Comparison of semi-automated and manual methods to measure the volume of prostate cancer on magnetic resonance imaging. Diagn Interv Imaging 2017; 98:423-428. [DOI: 10.1016/j.diii.2017.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 11/25/2022]
|
11
|
Wu X, Reinikainen P, Vanhanen A, Kapanen M, Vierikko T, Ryymin P, Hyödynmaa S, Kellokumpu-Lehtinen PL. Correlation between apparent diffusion coefficient value on diffusion-weighted MR imaging and Gleason score in prostate cancer. Diagn Interv Imaging 2016; 98:63-71. [PMID: 27687831 DOI: 10.1016/j.diii.2016.08.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/25/2016] [Accepted: 08/23/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate whether diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) correlates with prostate cancer aggressiveness and further to compare the diagnostic performance of ADC and normalized ADC (nADC: normalized to non-tumor tissue). PATIENTS AND METHODS Thirty pre-treatment patients (mean age, 69years; range: 59-78years) with prostate cancer underwent magnetic resonance imaging (MRI) examination, including DWI with three b values: 50, 400, and 800s/mm2. Both ADC and nADC were correlated with the Gleason score obtained through transrectal ultrasound-guided biopsy. RESULTS The tumor minimum ADC (ADCmin: the lowest ADC value within tumor) had an inverse correlation with the Gleason score (r=-0.43, P<0.05), and it was lower in patients with Gleason score 3+4 than in those with Gleason score 3+3 (0.54±0.11×103mm2/s vs. 0.64±0.12×10-3mm2/s, P<0.05). Both the nADCmin and nADCmean correlated with the Gleason score (r=-0.52 and r=-0.55, P<0.01; respectively), and they were lower in patients with Gleason score 3+4 than those with Gleason score 3+3 (P<0.01; respectively). Receiver operating characteristic (ROC) analysis showed that the area under the ROC curve was 0.765, 0.818, or 0.833 for the ADCmin, nADCmin, or nADCmean; respectively, in differentiating between Gleason score 3+4 and 3+3 tumors. CONCLUSION Tumor ADCmin, nADCmin, and nADCmean are useful markers to predict the aggressiveness of prostate cancer.
Collapse
Affiliation(s)
- X Wu
- Department of Oncology, Tampere University Hospital, Tampere, Finland; Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland.
| | - P Reinikainen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - A Vanhanen
- Department of Oncology, Tampere University Hospital, Tampere, Finland; Medical Imaging Centre, Department of Medical Physics, Tampere University Hospital, Tampere, Finland
| | - M Kapanen
- Department of Oncology, Tampere University Hospital, Tampere, Finland; Medical Imaging Centre, Department of Medical Physics, Tampere University Hospital, Tampere, Finland
| | - T Vierikko
- Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - P Ryymin
- Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland
| | - S Hyödynmaa
- Medical Imaging Centre, Department of Medical Physics, Tampere University Hospital, Tampere, Finland
| | - P-L Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland
| |
Collapse
|