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Yamamoto T, Okada H, Matsunaga N, Endo M, Tsuzuki T, Kajikawa K, Suzuki K. Clinical characteristics and pathological features of undetectable clinically significant prostate cancer on multiparametric magnetic resonance imaging: A single-center and retrospective study. J Clin Imaging Sci 2024; 14:20. [PMID: 38975058 PMCID: PMC11225522 DOI: 10.25259/jcis_37_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/05/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives The objectives of this study were to clarify the pathological features of clinically significant prostate cancer (csPC) that is undetectable on multiparametric magnetic resonance imaging (mpMRI). Material and Methods This single-center and retrospective study enrolled 33 men with prostate cancer (PC), encompassing 109 PC lesions, who underwent mpMRI before radical prostatectomy. Two radiologists independently assessed the mpMR images of all lesions and compared them with the pathological findings of PC. All PC lesions were marked on resected specimens using prostate imaging reporting and data system version 2.1 and classified into magnetic resonance imaging (MRI)-detectable and MRI-undetectable PC lesions. Each lesion was classified into csPC and clinically insignificant PC. Pathological characteristics were compared between MRI-detectable and MRI-undetectable csPC. Statistical analysis was performed to identify factors associated with MRI detectability. A logistic regression model was used to determine the factors associated with MRI-detectable and MRI-undetectable csPC. Results Among 109 PC lesions, MRI-detectable and MRI-undetectable PCs accounted for 31% (34/109) and 69% (75/109) of lesions, respectively. All MRI-detectable PCs were csPC. MRI-undetectable PCs included 30 cases of csPC (40%). The detectability of csPC on mpMRI was 53% (34/64). The MRI-undetectable csPC group had a shorter major diameter (10.6 ± 6.6 mm vs. 19.0 ± 6.9 mm, P < 0.001), shorter minor diameter (5.7 ± 2.9 mm vs. 10.7 ± 3.4 mm, P < 0.001), and lower percentage of lesions with Gleason pattern 5 (17% vs. 71%, P < 0.001). Shorter minor diameter (odds ratio [OR], 2.62; P = 0.04) and lower percentage of Gleason pattern 5 (OR, 24; P = 0.01) were independent predictors of MRI-undetectable csPC. Conclusion The pathological features of MRI-undetectable csPC included shorter minor diameter and lower percentage of Gleason pattern 5. csPC with shorter minor diameter may not be detected on mpMRI. Some MRI-undetectable csPC lesions exhibited sufficient size and Gleason pattern 5, emphasizing the need for further understanding of pathological factors contributing to MRI detectability.
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Affiliation(s)
- Takahiro Yamamoto
- Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hiroaki Okada
- Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Nozomu Matsunaga
- Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Makoto Endo
- Department of Radiological Technology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Keishi Kajikawa
- Department of Urology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan
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Lenfant L, Beitone C, Troccaz J, Beaugerie A, Rouprêt M, Seisen T, Renard-Penna R, Voros S, Mozer PC. Impact of Relative Volume Difference Between Magnetic Resonance Imaging and Three-dimensional Transrectal Ultrasound Segmentation on Clinically Significant Prostate Cancer Detection in Fusion Magnetic Resonance Imaging-targeted Biopsy. Eur Urol Oncol 2024; 7:430-437. [PMID: 37599199 DOI: 10.1016/j.euo.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/10/2023] [Accepted: 07/31/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Segmentation of three-dimensional (3D) transrectal ultrasound (TRUS) images is known to be challenging, and the clinician often lacks a reliable and easy-to-use indicator to assess its accuracy during the fusion magnetic resonance imaging (MRI)-targeted prostate biopsy procedure. OBJECTIVE To assess the effect of the relative volume difference between 3D-TRUS and MRI segmentation on the outcome of a targeted biopsy. DESIGN, SETTING, AND PARTICIPANTS All adult males who underwent an MRI-targeted prostate biopsy for clinically suspected prostate cancer between February 2012 and July 2021 were consecutively included. INTERVENTION All patients underwent a fusion MRI-targeted prostate biopsy with a Koelis device. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Three-dimensional TRUS and MRI prostate volumes were calculated using 3D prostate models issued from the segmentations. The primary outcome was the relative segmentation volume difference (SVD) between transrectal ultrasound and MRI divided by the MRI volume (SVD = MRI volume - TRUS volume/MRI volume) and its correlation with clinically significant prostate cancer (eg, International Society of Urological Pathology [ISUP] ≥2) positiveness on targeted biopsy cores. RESULTS AND LIMITATIONS Overall, 1721 patients underwent a targeted biopsy resulting in a total of 5593 targeted cores. The median relative SVD was significantly lower in patients diagnosed with clinically significant prostate cancer than in those with ISUP 0-1: (6.7% [interquartile range {IQR} -2.7, 13.6] vs 8.0% [IQR 3.3, 16.4], p < 0.01). A multivariate regression analysis showed that a relative SVD of >10% of the MRI volume was associated with a lower detection rate of clinically significant prostate cancer (odds ratio = 0.74 [95% confidence interval: 0.55-0.98]; p = 0.038). CONCLUSIONS A relative SVD of >10% of the MRI segmented volume was associated with a lower detection rate of clinically significant prostate cancer on targeted biopsy cores. The relative SVD can be used as a per-procedure quality indicator of 3D-TRUS segmentation. PATIENT SUMMARY A discrepancy of ≥10% between segmented magnetic resonance imaging and transrectal ultrasound volume is associated with a reduced ability to detect significant prostate cancer on targeted biopsy cores.
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Affiliation(s)
- Louis Lenfant
- Urologie, GRC n 5, Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France; CNRS, INSERM, Grenoble INP, TIMC, Univ. Grenoble Alpes, Grenoble, France; CNRS UMR 7222, INSERM U1150, Institut des Systèmes Intelligents et Robotique (ISIR), Sorbonne Université, Paris, France.
| | - Clément Beitone
- CNRS, INSERM, Grenoble INP, TIMC, Univ. Grenoble Alpes, Grenoble, France
| | - Jocelyne Troccaz
- CNRS, INSERM, Grenoble INP, TIMC, Univ. Grenoble Alpes, Grenoble, France
| | - Aurélien Beaugerie
- Urologie, GRC n 5, Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Morgan Rouprêt
- Urologie, GRC n 5, Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Thomas Seisen
- Urologie, GRC n 5, Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Raphaele Renard-Penna
- Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Sandrine Voros
- CNRS, INSERM, Grenoble INP, TIMC, Univ. Grenoble Alpes, Grenoble, France
| | - Pierre C Mozer
- Urologie, GRC n 5, Predictive Onco-Urology, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France; CNRS UMR 7222, INSERM U1150, Institut des Systèmes Intelligents et Robotique (ISIR), Sorbonne Université, Paris, France
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Sun YK, Zhou BY, Miao Y, Shi YL, Xu SH, Wu DM, Zhang L, Xu G, Wu TF, Wang LF, Yin HH, Ye X, Lu D, Han H, Xiang LH, Zhu XX, Zhao CK, Xu HX. Three-dimensional convolutional neural network model to identify clinically significant prostate cancer in transrectal ultrasound videos: a prospective, multi-institutional, diagnostic study. EClinicalMedicine 2023; 60:102027. [PMID: 37333662 PMCID: PMC10276260 DOI: 10.1016/j.eclinm.2023.102027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/22/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Background Identifying patients with clinically significant prostate cancer (csPCa) before biopsy helps reduce unnecessary biopsies and improve patient prognosis. The diagnostic performance of traditional transrectal ultrasound (TRUS) for csPCa is relatively limited. This study was aimed to develop a high-performance convolutional neural network (CNN) model (P-Net) based on a TRUS video of the entire prostate and investigate its efficacy in identifying csPCa. Methods Between January 2021 and December 2022, this study prospectively evaluated 832 patients from four centres who underwent prostate biopsy and/or radical prostatectomy. All patients had a standardised TRUS video of the whole prostate. A two-dimensional CNN (2D P-Net) and three-dimensional CNN (3D P-Net) were constructed using the training cohort (559 patients) and tested on the internal validation cohort (140 patients) as well as on the external validation cohort (133 patients). The performance of 2D P-Net and 3D P-Net in predicting csPCa was assessed in terms of the area under the receiver operating characteristic curve (AUC), biopsy rate, and unnecessary biopsy rate, and compared with the TRUS 5-point Likert score system as well as multiparametric magnetic resonance imaging (mp-MRI) prostate imaging reporting and data system (PI-RADS) v2.1. Decision curve analyses (DCAs) were used to determine the net benefits associated with their use. The study is registered at https://www.chictr.org.cn with the unique identifier ChiCTR2200064545. Findings The diagnostic performance of 3D P-Net (AUC: 0.85-0.89) was superior to TRUS 5-point Likert score system (AUC: 0.71-0.78, P = 0.003-0.040), and similar to mp-MRI PI-RADS v2.1 score system interpreted by experienced radiologists (AUC: 0.83-0.86, P = 0.460-0.732) and 2D P-Net (AUC: 0.79-0.86, P = 0.066-0.678) in the internal and external validation cohorts. The biopsy rate decreased from 40.3% (TRUS 5-point Likert score system) and 47.6% (mp-MRI PI-RADS v2.1 score system) to 35.5% (2D P-Net) and 34.0% (3D P-Net). The unnecessary biopsy rate decreased from 38.1% (TRUS 5-point Likert score system) and 35.2% (mp-MRI PI-RADS v2.1 score system) to 32.0% (2D P-Net) and 25.8% (3D P-Net). 3D P-Net yielded the highest net benefit according to the DCAs. Interpretation 3D P-Net based on a prostate grayscale TRUS video achieved satisfactory performance in identifying csPCa and potentially reducing unnecessary biopsies. More studies to determine how AI models better integrate into routine practice and randomized controlled trials to show the values of these models in real clinical applications are warranted. Funding The National Natural Science Foundation of China (Grants 82202174 and 82202153), the Science and Technology Commission of Shanghai Municipality (Grants 18441905500 and 19DZ2251100), Shanghai Municipal Health Commission (Grants 2019LJ21 and SHSLCZDZK03502), Shanghai Science and Technology Innovation Action Plan (21Y11911200), and Fundamental Research Funds for the Central Universities (ZD-11-202151), Scientific Research and Development Fund of Zhongshan Hospital of Fudan University (Grant 2022ZSQD07).
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Affiliation(s)
- Yi-Kang Sun
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Bo-Yang Zhou
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Yao Miao
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumour, Shanghai Tenth People's Hospital, Ultrasound Institute of Research and Education, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound in Diagnosis and Treatment, Shanghai, China
| | - Yi-Lei Shi
- MedAI Technology (Wuxi) Co., Ltd., Wuxi, China
| | - Shi-Hao Xu
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China
| | - Dao-Ming Wu
- Department of Ultrasound, Fujian Provincial Hospital, Fujian, China
| | - Lei Zhang
- MedAI Technology (Wuxi) Co., Ltd., Wuxi, China
| | - Guang Xu
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumour, Shanghai Tenth People's Hospital, Ultrasound Institute of Research and Education, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound in Diagnosis and Treatment, Shanghai, China
| | - Ting-Fan Wu
- Bayer Healthcare, Radiology, Shanghai, China
| | - Li-Fan Wang
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Hao-Hao Yin
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Xin Ye
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Dan Lu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Hong Han
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Li-Hua Xiang
- Department of Medical Ultrasound, Center of Minimally Invasive Treatment for Tumour, Shanghai Tenth People's Hospital, Ultrasound Institute of Research and Education, School of Medicine, Tongji University, Shanghai, China
- Shanghai Engineering Research Center of Ultrasound in Diagnosis and Treatment, Shanghai, China
| | - Xiao-Xiang Zhu
- Chair of Data Science in Earth Observation, Technical University of Munich, Munich, Germany
| | - Chong-Ke Zhao
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
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Suguino RK, Mussi TC, Coelho FMA, Baroni RH. Prostate imaging features on magnetic resonance imaging of young patients. EINSTEIN-SAO PAULO 2022; 20:eAO0024. [PMID: 36477522 DOI: 10.31744/einstein_journal/2022ao0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify magnetic resonance imaging findings of the prostate in young adults, including symptomatic and asymptomatic patients. The aim of this study is to evaluate the main aspects of prostate imaging in young patients. METHODS A total of 102 patients under 40 years of age, who underwent prostate magnetic resonance imaging between January 2016 and January 2019, were included in this study. The patients were divided into two groups: symptomatic for prostatitis (Group 1) and asymptomatic (Group 2). Magnetic resonance imaging scans were anonymized and interpreted by a radiologist blinded for clinical information. The study evaluated peripheral zone signal in T2-weighted sequences, diffusion and apparent diffusion coefficient map; peripheral zone enhancement pattern; seminal vesicles and periprostatic fat. RESULTS All evaluated criteria did not present statistically significant differences between the two groups. The most common pattern was heterogeneous hyposignal on T2 (57.9% in Group 1 and 57.8% in Group 2; p=0.506), mild diffuse / wedge-shaped areas of hypointensity on apparent diffusion coefficient map (61.4% in Group 1 and 64.4% in Group 2; p=0.931) and early post-contrast enhancement (73.7% in Group 1 and 68.9% in Group 2, p=0719). CONCLUSION The magnetic resonance imaging aspect of young patients showed no differences between symptomatic and asymptomatic patients.
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Multiparametric MRI for Staging of Prostate Cancer: A Multicentric Analysis of Predictive Factors to Improve Identification of Extracapsular Extension before Radical Prostatectomy. Cancers (Basel) 2022; 14:cancers14163966. [PMID: 36010963 PMCID: PMC9406654 DOI: 10.3390/cancers14163966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary In this multicentric study, we tested the accuracy of multiparametric magnetic resonance imaging (mpMRI) in detecting extracapsular extension (ECE) out of the prostate in order to plan surgical sparing of neurovascular bundles in radical prostatectomy. Univariate and multivariate logistic regression analyses were performed to identify other risk factors for ECE. We found that it has a good ability to exclude extracapsular extension but a poor ability to identify it correctly. Risk factors other than mpMRI that predicted ECE were as follows: prostatic specific antigen, digital rectal examination, ratio of positive cores, and biopsy grade group. We suggest that using mpMRI exclusively should not be recommended to decide on surgical approaches. Abstract The correct identification of extracapsular extension (ECE) of prostate cancer (PCa) on multiparametric magnetic resonance imaging (mpMRI) is crucial for surgeons in order to plan the nerve-sparing approach in radical prostatectomy. Nerve-sparing strategies allow for better outcomes in preserving erectile function and urinary continence, notwithstanding this can be penalized with worse oncologic results. The aim of this study was to assess the ability of preoperative mpMRI to predict ECE in the final prostatic specimen (PS) and identify other possible preoperative predictive factors of ECE as a secondary end-point. We investigated a database of two high-volume hospitals to identify men who underwent a prostate biopsy with a pre-biopsy mpMRI and a subsequent RP. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of mpMRI in predicting ECE were calculated. A univariate analysis was performed to find the association between image staging and pathological staging. A multivariate logistic regression was performed to investigate other preoperative predictive factors. A total of 1147 patients were selected, and 203 out of the 1147 (17.7%) patients were classified as ECE according to the mpMRI. ECE was reported by pathologists in 279 out of the 1147 PS (24.3%). The PPV was 0.58, the NPV was 0.72, the sensitivity was 0.32, and the specificity was 0.88. The multivariate analysis found that PSA (OR 1.057, C.I. 95%, 1.016–1.100, p = 0.006), digital rectal examination (OR 0.567, C.I. 95%, 0.417–0.770, p = 0.0001), ratio of positive cores (OR 9.687, C.I. 95%, 3.744–25.006, p = 0.0001), and biopsy grade in prostate biopsy (OR 1.394, C.I. 95%, 1.025–1.612, p = 0.0001) were independent factors of ECE. The mpMRI has a great ability to exclude ECE, notwithstanding that low sensitivity is still an important limitation of the technique.
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A comprehensive prostate biopsy standardization system according to quantitative multiparametric MRI and PSA value: P.R.O.S.T score. World J Urol 2022; 40:2245-2253. [DOI: 10.1007/s00345-022-04102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022] Open
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Multiparametric ultrasound versus multiparametric MRI to diagnose prostate cancer (CADMUS): a prospective, multicentre, paired-cohort, confirmatory study. Lancet Oncol 2022; 23:428-438. [DOI: 10.1016/s1470-2045(22)00016-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022]
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Bhuiyan EH, Dewdney A, Weinreb J, Galiana G. Feasibility of diffusion weighting with a local inside-out nonlinear gradient coil for prostate MRI. Med Phys 2021; 48:5804-5818. [PMID: 34287937 DOI: 10.1002/mp.15100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/04/2021] [Accepted: 06/23/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Prostate cancer remains the 2nd leading cancer killer of men, yet it is also a disease with a high rate of overtreatment. Diffusion weighted imaging (DWI) has shown promise as a reliable, grade-sensitive imaging method, but it is limited by low image quality. Currently, DWI quality image is directly related to low gradient amplitudes, since weak gradients must be compensated with long echo times. METHODS We propose a new type of MRI accessory, an "inside-out" and nonlinear gradient, whose sole purpose is to deliver diffusion encoding to a region of interest. Performance was simulated in OPERA and the resulting fields were used to simulate DWI with two compartment and kurtosis models. Experiments with a nonlinear head gradient prove the accuracy of DWI and ADC maps diffusion encoded with nonlinear gradients. RESULTS Simulations validated thermal and mechanical safety while showing a 5 to 10-fold increase in gradient strength over prostate. With these strengths, lesion CNR in ADC maps approximately doubled for a range of anatomical positions. Proof-of-principle experiments show that spatially varying b-values can be corrected for accurate DWI and ADC. CONCLUSIONS Dedicated nonlinear diffusion encoding hardware could improve prostate DWI.
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Affiliation(s)
| | | | - Jeffrey Weinreb
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA
| | - Gigi Galiana
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA
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Stanzione A, Creta M, Imbriaco M, La Rocca R, Capece M, Esposito F, Imbimbo C, Fusco F, Celentano G, Napolitano L, Mangiapia F, Mirone V, Longo N. Attitudes and perceptions towards multiparametric magnetic resonance imaging of the prostate: A national survey among Italian urologists. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348956 DOI: 10.4081/aiua.2020.4.291] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aimed to assess the attitudes and perceptions towards multiparametric magnetic resonance imaging (mpMRI) of the prostate among Italian urologists. MATERIAL AND METHODS A national, web-based survey was performed. A questionnaire composed of 18 multiple choice questions was e-mailed to 941 currently active urologists, members of the Italian Society of Urology. Preserving anonymity, respondents' demographics were collected (e.g. geographic region, type of workplace, prostate procedures performed) as well as data concerning their attitudes and perceptions towards mpMRI (e.g. indications deemed appropriate, degree of confidence in mpMRI results). Data were expressed as raw numbers and percentages of survey answers. RESULTS In total, 98 responses were received (participation rate = 10.4%). Respondents mostly worked in urban areas (96%) and primarily in hospital settings (89%), while 48% of them worked in southern Italy. 97% of respondents considered mpMRI useful to detect Prostate Cancer (PCa) in patients with prior negative biopsy, 64% in biopsy-naïve patients and 60% for PCa pre-operatory staging. About half (42%) of the participants declared that mpMRI results frequently lead them to change PCa management strategy. Standardization of mpMRI acquisition and reporting was partially unsatisfactory. Reported waiting time for mpMRI scans was longer than 4 weeks for 51% of respondents. The major limitation of this survey includes the small number of participants. CONCLUSIONS Prostate mpMRI is used by Italian urologists mainly for detection and for pre-operative staging of PCa. Further improvements in terms of mpMRI availability and report standardization are required.
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Affiliation(s)
- Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples.
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Fabio Esposito
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy..
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Ferdinando Fusco
- Department of Woman Child and of General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples.
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples.
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PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review. AJR Am J Roentgenol 2020; 216:3-19. [PMID: 32812795 DOI: 10.2214/ajr.20.24268] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The steadily increasing demand for diagnostic prostate MRI has led to concerns regarding the lack of access to and the availability of qualified MRI scanners and sufficiently experienced radiologists, radiographers, and technologists to meet the demand. Solutions must enhance operational benefits without compromising diagnostic performance, quality, and delivery of service. Solutions should also mitigate risks such as decreased reader confidence and referrer engagement. One approach may be the implementation of MRI without the use gadolinium-based contrast medium (bipara-metric MRI), but only if certain prerequisites such as high-quality imaging, expert interpretation quality, and availability of patient recall or on-table monitoring are mandated. Alternatively, or in combination, a clinical risk-based approach could be used for protocol selection, specifically, which biopsy-naive men need MRI with contrast medium (multiparametric MRI). There is a need for prospective studies in which biopsy decisions are made according to MRI without contrast enhancement. Such studies must define clinical and operational benefits and identify which patient groups can be scanned successfully without contrast enhancement. These higher-quality data are needed before the Prostate Imaging Reporting and Data System (PI-RADS) Committee can make evidence-based recommendations about MRI without contrast enhancement as an initial diagnostic approach for prostate cancer workup.
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Prostate MRI: Practical guidelines for interpreting and reporting according to PI-RADS version 2.1. RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sánchez-Oro R, Nuez JT, Martínez-Sanz G, Ortega QG, Bleila M. Prostate MRI: practical guidelines for interpreting and reporting according to PI-RADS version 2.1. RADIOLOGIA 2020; 62:437-451. [PMID: 33268134 DOI: 10.1016/j.rx.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
The increasing precision of multiparametric magnetic resonance imaging of the prostate, together with greater experience and standardization in its interpretation, has given this technique an important role in the management of prostate cancer, the most prevalent non-cutaneous cancer in men. This article reviews the concepts in PI-RADS version 2.1 for estimating the probability and zonal location of significant tumors of the prostate, using a practical approach that includes current considerations about the prerequisites for carrying out the test and recommendations for interpreting the findings. It emphasizes benign findings that can lead to confusion and the criteria for evaluating the probability of local spread, which must be included in the structured report.
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Affiliation(s)
- R Sánchez-Oro
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España.
| | - J Torres Nuez
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| | - G Martínez-Sanz
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| | - Q Grau Ortega
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| | - M Bleila
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
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13
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Padhani AR, Schoots I, Villeirs G. Contrast Medium or No Contrast Medium for Prostate Cancer Diagnosis. That Is the Question. J Magn Reson Imaging 2020; 53:13-22. [PMID: 32363651 DOI: 10.1002/jmri.27180] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/20/2022] Open
Abstract
The benefits and drawbacks of the dynamic contrast-enhanced MRI sequence for prostate cancer diagnosis are increasingly being recognized, with many centers adopting the biparametric (bp) MRI approach as the default initial approach. The abandonment of the routine use of contrast medium requires an assessment of the loss of diagnostic power against the gains in operational logistics, costs, time, capacity, and side effects. It is the balance of these factors weighted against the clinical priorities of patients that determines which patient groups can safely avoid dynamic contrast enhancement. Although systematic reviews and individual studies are broadly supportive of the bpMRI approach, the pathway impacts for men with suspected cancer using the bpMRI approach are still not well documented for clinical practice. Robust prospectively acquired data for bpMRI regarding biopsy avoidance, detection of clinically significant and insignificant cancers, and for increasing the precision of tumor grade and volume are needed. There is a requirement for prospective, randomized, or blinded head-to-head, multicenter studies, addressing the noninferiority of biopsy yields prompted by bpMRI and multiparametric MRI approaches. These studies should more precisely define patient groups where the benefits and harms of contrast enhancement are aligned to their clinical priorities. Only then can we be confident in recommending bpMRI as an initial diagnostic approach for prostate cancer diagnosis. Level of Evidence 1 Technical Efficacy Stage 5.
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Affiliation(s)
- Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK
| | - Ivo Schoots
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Geert Villeirs
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
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14
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Computer-aided diagnosis system for characterizing ISUP grade ≥ 2 prostate cancers at multiparametric MRI: A cross-vendor evaluation. Diagn Interv Imaging 2019; 100:801-811. [DOI: 10.1016/j.diii.2019.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/30/2019] [Accepted: 06/25/2019] [Indexed: 12/28/2022]
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15
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Bardet F, Frontczak A, Schneider A, Delattre B, Kleinclauss F, Cormier L. IRM de prostate et dépistage : enquête de la pratique auprès des médecins généralistes de Bourgogne-Franche-Comté. Prog Urol 2019; 29:974-980. [DOI: 10.1016/j.purol.2019.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/13/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
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16
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Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, Tempany CM, Choyke PL, Cornud F, Margolis DJ, Thoeny HC, Verma S, Barentsz J, Weinreb JC. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol 2019; 76:340-351. [DOI: 10.1016/j.eururo.2019.02.033] [Citation(s) in RCA: 577] [Impact Index Per Article: 115.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/25/2019] [Indexed: 02/08/2023]
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17
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Barentsz JO, van der Leest MMG, Israël B. Reply to Jochen Walz. Let's Keep It at One Step at a Time: Why Biparametric Magnetic Resonance Imaging Is Not the Priority Today. Eur Urol 2019;76:582-3: How to Implement High-quality, High-volume Prostate Magnetic Resonance Imaging: Gd Contrast Can Help but Is Not the Major Issue. Eur Urol 2019; 76:584-585. [PMID: 31409496 DOI: 10.1016/j.eururo.2019.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/24/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Jelle O Barentsz
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Marloes M G van der Leest
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Israël
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Comparison of bone lesion distribution between prostate cancer and multiple myeloma with whole-body MRI. Diagn Interv Imaging 2019; 100:295-302. [PMID: 30704946 DOI: 10.1016/j.diii.2018.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/20/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE To assess the distribution of bone lesions in patients with prostate cancer (PCa) and those with multiple myeloma (MM) using whole-body magnetic resonance imaging (MRI); and to assess the added value of four anatomical regions located outside the thoraco-lumbo-pelvic area to detect the presence of bone lesions in a patient-based perspective. MATERIALS AND METHODS Fifty patients (50 men; mean age, 67±10 [SD] years; range, 59-87 years) with PCa and forty-seven patients (27 women, 20 men; mean age, 62.5±9 [SD] years; range, 47-90 years) with MM were included. Three radiologists assessed bone involvement in seven anatomical areas reading all MRI sequences. RESULTS In patients with PCa, there was a cranio-caudal increasing prevalence of metastases (22% [11/50] in the humeri and cervical spine to 60% [30/50] in the pelvis). When the thoraco-lumbo-pelvic region was not involved, the prevalence of involvement of the cervical spine, proximal humeri, ribs, or proximal femurs was 0% in patients with PCa and≥4% (except for the cervical spine, 0%) in those with MM. CONCLUSION In patients with PCa, there is a cranio-caudal positive increment in the prevalences of metastases and covering the thoraco-lumbo-pelvic area is sufficient to determine the metastatic status of a patient with PCa. In patients with MM, there is added value of screening all regions, except the cervical spine, to detect additional lesions.
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19
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Booker MT, Silva E, Rosenkrantz AB. National Private Payer Coverage of Prostate MRI. J Am Coll Radiol 2019; 16:24-29. [DOI: 10.1016/j.jacr.2018.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 07/07/2018] [Indexed: 12/27/2022]
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20
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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.
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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
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21
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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
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22
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Couñago F, Sancho G, Gómez-Iturriaga A, Henríquez I. Multiparametric MRI for prostate cancer: a national survey of patterns of practice among radiation oncologists in Spain. Clin Transl Oncol 2018; 20:1484-1491. [PMID: 29992463 DOI: 10.1007/s12094-018-1919-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate patterns of practice among Spanish radiation oncologists in the use of multiparametric magnetic resonance imaging (mpMRI) for the treatment of prostate cancer (PCa). We evaluated (1) access to mpMRI, (2) current clinical practices, and (3) physician expectations of mpMRI. METHODS Cross-sectional survey of 118 radiation oncologists at 75 Radiation Oncology (RO) departments in Spain. RESULTS A total of 55 radiation oncologists from 52 RO departments (52/75; 69%) completed the survey. Prostate mpMRI is performed at 94.5% of the centres that provided data. The most common indications for mpMRI in routine clinical practice were: (1) detection/localization of the tumour prior to second biopsy (82.7%), (2) cancer staging (80.8%), and (3) detection of recurrence after definitive treatment (80.8%). Most respondents (72.7%) reported modifying the primary radiotherapy treatment when mpMRI findings indicate a more advanced T stage with a resultant change in the risk group. Most respondents (90.5%) treat macroscopic local recurrence after prostatectomy with high doses, ranging from 71 to 83 Gy; in 37.7% of cases, the full dose is delivered to the entire prostate bed. In pelvic nodal recurrence, more than half (59.3%) of the respondents reported performing elective pelvic radiotherapy, including the prostate bed, with a boost to the involved nodes. CONCLUSIONS This survey shows that prostate mpMRI is routinely used by radiation oncologists in Spain in a wide range of clinical scenarios. The findings reported here underscore the need to standardize treatment protocols for definitive and salvage radiotherapy in patients evaluated with mpMRI.
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Affiliation(s)
- F Couñago
- Department of Radiation Oncology, Hospital Universitario Quirónsalud, Madrid, Universidad Europea de Madrid, Calle Diego de Velázquez, 2, Pozuelo de Alarcón, 28223, Madrid, Spain.
| | - G Sancho
- Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Gómez-Iturriaga
- Department of Radiation Oncology, Hospital Universitario Cruces, Biocruces Health Research Institute, Barakaldo, Spain
| | - I Henríquez
- Department of Radiation Oncology, Hospital Universitario de Sant Joan, Institute d'Investigació Sanitaria Pere Virgili (IISPV), Reus, Spain
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23
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Ploussard G, Borgmann H, Briganti A, de Visschere P, Fütterer JJ, Gandaglia G, Heidegger I, Kretschmer A, Mathieu R, Ost P, Sooriakumaran P, Surcel C, Tilki D, Tsaur I, Valerio M, van den Bergh R. Positive pre-biopsy MRI: are systematic biopsies still useful in addition to targeted biopsies? World J Urol 2018; 37:243-251. [PMID: 29967944 DOI: 10.1007/s00345-018-2399-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The diagnostic strategy implementing multiparametric magnet resonance tomography (mpMRI) and targeted biopsies (TB) improves the detection and characterization of significant prostate cancer (PCa). We aimed to assess the clinical usefulness of systematic biopsies (SB) in the setting of patients having a pre-biopsy positive MRI. METHODS A review of the literature was performed in March 2018. All studies investigating the performance of SB in addition to TB (all techniques) were assessed, both in the biopsy-naïve and repeat biopsy setting. RESULTS Evidence demonstrates that TB improves the detection of index-significant PCa compared with SB alone, in both initial and repeat biopsy settings. However, the combination of both TB and SB improved the overall (around 30%) and significant (around 10%) PCa detection rates as compared with TB alone. Significant differences between both biopsy approaches exist regarding cancer location favoring SB for the far lateral sampling, and TB for the anterior zone. Main current pitfalls of pure TB strategy are the learning curve and experience required for mpMRI reading and biopsy targeting, as well as the precision assessment in TB techniques. CONCLUSION A pure TB strategy omitting SB leads to the risk of missing up to 15% of significant cancer, due to limitations of mpMRI performance/reading and of precision during lesion targeting. SB remain necessary, in addition to the TB, to obtain the most accurate assessment of the entire prostate gland in this sub-group of patients at risk of significant disease.
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Affiliation(s)
- Guillaume Ploussard
- Department of Urology, Saint Jean Languedoc/La Croix du Sud Hospital, 20, route de Revel, 31400, Toulouse, France. .,IUCT-O, Avenue Joliot-Curie, 31000, Toulouse, France.
| | - Hendrik Borgmann
- Department of Urology, University Hospital of Mainz, Mainz, Germany
| | - Alberto Briganti
- Department of Urology, Urological Research Institute, Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | | | - Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Giorgio Gandaglia
- Department of Urology, Urological Research Institute, Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | - Isabel Heidegger
- Department of Urology, University Hospital of Innsbrück, Innsbrück, Austria
| | | | | | - Piet Ost
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium
| | | | - Cristian Surcel
- Department of Urology, Fundeni Clinical Institute, Bucharest, Romania
| | - Derya Tilki
- Department of Urology, Martini Klinik, Hamburg, Germany
| | - Igor Tsaur
- Department of Urology, University Hospital of Mainz, Mainz, Germany
| | - Massimo Valerio
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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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]
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25
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Dinh AH, Melodelima C, Souchon R, Moldovan PC, Bratan F, Pagnoux G, Mège-Lechevallier F, Ruffion A, Crouzet S, Colombel M, Rouvière O. Characterization of Prostate Cancer with Gleason Score of at Least 7 by Using Quantitative Multiparametric MR Imaging: Validation of a Computer-aided Diagnosis System in Patients Referred for Prostate Biopsy. Radiology 2018; 287:525-533. [DOI: 10.1148/radiol.2017171265] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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26
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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]
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27
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Walz J. The "PROMIS" of Magnetic Resonance Imaging Cost Effectiveness in Prostate Cancer Diagnosis? Eur Urol 2017; 73:31-32. [PMID: 28965689 DOI: 10.1016/j.eururo.2017.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/02/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France.
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28
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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.
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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
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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]
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