1
|
Couchoux T, Jaouen T, Melodelima-Gonindard C, Baseilhac P, Branchu A, Arfi N, Aziza R, Barry Delongchamps N, Bladou F, Bratan F, Brunelle S, Colin P, Correas JM, Cornud F, Descotes JL, Eschwege P, Fiard G, Guillaume B, Grange R, Grenier N, Lang H, Lefèvre F, Malavaud B, Marcelin C, Moldovan PC, Mottet N, Mozer P, Potiron E, Portalez D, Puech P, Renard-Penna R, Roumiguié M, Roy C, Timsit MO, Tricard T, Villers A, Walz J, Debeer S, Mansuy A, Mège-Lechevallier F, Decaussin-Petrucci M, Badet L, Colombel M, Ruffion A, Crouzet S, Rabilloud M, Souchon R, Rouvière O. Performance of a Region of Interest-based Algorithm in Diagnosing International Society of Urological Pathology Grade Group ≥2 Prostate Cancer on the MRI-FIRST Database-CAD-FIRST Study. Eur Urol Oncol 2024; 7:1113-1122. [PMID: 38493072 DOI: 10.1016/j.euo.2024.03.003] [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: 02/01/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND AND OBJECTIVE Prostate multiparametric magnetic resonance imaging (MRI) shows high sensitivity for International Society of Urological Pathology grade group (GG) ≥2 cancers. Many artificial intelligence algorithms have shown promising results in diagnosing clinically significant prostate cancer on MRI. To assess a region-of-interest-based machine-learning algorithm aimed at characterising GG ≥2 prostate cancer on multiparametric MRI. METHODS The lesions targeted at biopsy in the MRI-FIRST dataset were retrospectively delineated and assessed using a previously developed algorithm. The Prostate Imaging-Reporting and Data System version 2 (PI-RADSv2) score assigned prospectively before biopsy and the algorithm score calculated retrospectively in the regions of interest were compared for diagnosing GG ≥2 cancer, using the areas under the curve (AUCs), and sensitivities and specificities calculated with predefined thresholds (PIRADSv2 scores ≥3 and ≥4; algorithm scores yielding 90% sensitivity in the training database). Ten predefined biopsy strategies were assessed retrospectively. KEY FINDINGS AND LIMITATIONS After excluding 19 patients, we analysed 232 patients imaged on 16 different scanners; 85 had GG ≥2 cancer at biopsy. At patient level, AUCs of the algorithm and PI-RADSv2 were 77% (95% confidence interval [CI]: 70-82) and 80% (CI: 74-85; p = 0.36), respectively. The algorithm's sensitivity and specificity were 86% (CI: 76-93) and 65% (CI: 54-73), respectively. PI-RADSv2 sensitivities and specificities were 95% (CI: 89-100) and 38% (CI: 26-47), and 89% (CI: 79-96) and 47% (CI: 35-57) for thresholds of ≥3 and ≥4, respectively. Using the PI-RADSv2 score to trigger a biopsy would have avoided 26-34% of biopsies while missing 5-11% of GG ≥2 cancers. Combining prostate-specific antigen density, the PI-RADSv2 and algorithm's scores would have avoided 44-47% of biopsies while missing 6-9% of GG ≥2 cancers. Limitations include the retrospective nature of the study and a lack of PI-RADS version 2.1 assessment. CONCLUSIONS AND CLINICAL IMPLICATIONS The algorithm provided robust results in the multicentre multiscanner MRI-FIRST database and could help select patients for biopsy. PATIENT SUMMARY An artificial intelligence-based algorithm aimed at diagnosing aggressive cancers on prostate magnetic resonance imaging showed results similar to expert human assessment in a prospectively acquired multicentre test database.
Collapse
Affiliation(s)
- Thibaut Couchoux
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | | | - Pierre Baseilhac
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Arthur Branchu
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Arfi
- Department of Urology, Hôpital Saint Joseph Saint Luc, Lyon, France
| | - Richard Aziza
- Department of Radiology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | | | - Franck Bladou
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Flavie Bratan
- Department of Diagnostic and Interventional Imaging, Hôpital Saint Joseph Saint Luc, Lyon, France
| | - Serge Brunelle
- Department of Radiology and Medical Imaging, Institut Paoli-Calmettes Cancer Center, Marseille, France
| | - Pierre Colin
- Department of Urology, Hôpital privé La Louvrière, Lille, France
| | - Jean-Michel Correas
- Department of Radiology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Cornud
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Luc Descotes
- Université Grenoble Alpes, Grenoble, France; Department of Urology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Pascal Eschwege
- Department of Urology, Centre Hospitalier Régional et Universitaire de Nancy, Vandoeuvre, France
| | - Gaelle Fiard
- Université Grenoble Alpes, Grenoble, France; Department of Urology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Bénédicte Guillaume
- Department of Radiology, Centre Hospitalier Universitaire de Grenoble, Université Grenoble Apes, Grenoble, France
| | - Rémi Grange
- Department of Radiology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Nicolas Grenier
- Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | - Hervé Lang
- Department of Urology, Centre Hospitalier Universitaire de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Frédéric Lefèvre
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Nancy, Vandoeuvre, France
| | - Bernard Malavaud
- Department of Urology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Clément Marcelin
- Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France
| | - Paul C Moldovan
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Mottet
- Department of Urology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Pierre Mozer
- Department of Urology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Potiron
- Clinique Urologique de Nantes, Saint-Herblain, France
| | - Daniel Portalez
- Department of Radiology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Philippe Puech
- Department of Radiology, Centre Hospitalier Régional et Universitaire de Lille, Lille, France
| | - Raphaele Renard-Penna
- Department of Radiology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; GRC no 5, ONCOTYPE-URO, Sorbonne Universités, Paris, France
| | - Matthieu Roumiguié
- Department of Urology, Toulouse-Rangueil University Hospital, Toulouse France
| | - Catherine Roy
- Department of Radiology B, Centre Hospitalier Universitaire de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Marc-Olivier Timsit
- Department of Urology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thibault Tricard
- Department of Urology, Centre Hospitalier Universitaire de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Arnauld Villers
- Department of Urology, Univ. Lille, CHU Lille, Lille, France
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Center, Marseille, France
| | - Sabine Debeer
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Adeline Mansuy
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | | | - Lionel Badet
- Department of Urology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France; Department of Urology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Université Lyon 1, Université de Lyon, Lyon, France
| | - Marc Colombel
- Department of Urology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Université Lyon 1, Université de Lyon, Lyon, France
| | - Alain Ruffion
- Université Lyon 1, Université de Lyon, Lyon, France; Department of Urology, Centre Hospitalier Lyon Sud, Hospices Cibvils de Lyon, Pierre-Bénite, France
| | - Sébastien Crouzet
- LabTau, INSERM Unit 1032, Lyon, France; Department of Urology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Université Lyon 1, Université de Lyon, Lyon, France
| | - Muriel Rabilloud
- Université Lyon 1, Université de Lyon, Lyon, France; Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
| | | | - Olivier Rouvière
- Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; LabTau, INSERM Unit 1032, Lyon, France; Université Lyon 1, Université de Lyon, Lyon, France.
| |
Collapse
|
2
|
Jaouen T, Souchon R, Moldovan PC, Bratan F, Duran A, Hoang-Dinh A, Di Franco F, Debeer S, Dubreuil-Chambardel M, Arfi N, Ruffion A, Colombel M, Crouzet S, Gonindard-Melodelima C, Rouvière O. Characterization of high-grade prostate cancer at multiparametric MRI using a radiomic-based computer-aided diagnosis system as standalone and second reader. Diagn Interv Imaging 2023; 104:465-476. [PMID: 37345961 DOI: 10.1016/j.diii.2023.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/16/2023] [Accepted: 04/18/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE The purpose of this study was to develop and test across various scanners a zone-specific region-of-interest (ROI)-based computer-aided diagnosis system (CAD) aimed at characterizing, on MRI, International Society of Urological Pathology (ISUP) grade≥2 prostate cancers. MATERIALS AND METHODS ROI-based quantitative models were selected in multi-vendor training (265 pre-prostatectomy MRIs) and pre-test (112 pre-biopsy MRIs) datasets. The best peripheral and transition zone models were combined and retrospectively assessed in internal (158 pre-biopsy MRIs) and external (104 pre-biopsy MRIs) test datasets. Two radiologists (R1/R2) retrospectively delineated the lesions targeted at biopsy in test datasets. The CAD area under the receiver operating characteristic curve (AUC) for characterizing ISUP≥2 cancers was compared to that of the Prostate Imaging-Reporting and Data System version2 (PI-RADSv2) score prospectively assigned to targeted lesions. RESULTS The best models used the 25th apparent diffusion coefficient (ADC) percentile in transition zone and the 2nd ADC percentile and normalized wash-in rate in peripheral zone. The PI-RADSv2 AUCs were 82% (95% confidence interval [CI]: 74-87) and 86% (95% CI: 81-91) in the internal and external test datasets respectively. They were not different from the CAD AUCs obtained with R1 and R2 delineations, in the internal (82% [95% CI: 76-89], P = 0.95 and 85% [95% CI: 78-91], P = 0.55) and external (82% [95% CI: 74-91], P = 0.41 and 86% [95% CI:78-95], P = 0.98) test datasets. The CAD yielded sensitivities of 86-89% and 90-91%, and specificities of 64-65% and 69-75% in the internal and external test datasets respectively. CONCLUSION The CAD performance for characterizing ISUP grade≥2 prostate cancers on MRI is not different from that of PI-RADSv2 score across two test datasets.
Collapse
Affiliation(s)
| | | | - Paul C Moldovan
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Vascular and Urinary Imaging, Lyon, 69003, France
| | - Flavie Bratan
- Hôpital Saint Joseph Saint Luc, Department of Radiology, Lyon, 69007, France
| | - Audrey Duran
- Univ Lyon, CNRS, Inserm, INSA Lyon, UCBL, CREATIS, UMR5220, U1294, Villeurbanne, 69100, France
| | - Au Hoang-Dinh
- INSERM, LabTAU, U1032, Lyon, 69003, France; Hanoi Medical University, Department of Radiology, Hanoi, 116001, Vietnam
| | - Florian Di Franco
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Vascular and Urinary Imaging, Lyon, 69003, France
| | - Sabine Debeer
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Vascular and Urinary Imaging, Lyon, 69003, France
| | - Marine Dubreuil-Chambardel
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Vascular and Urinary Imaging, Lyon, 69003, France
| | - Nicolas Arfi
- Hôpital Saint Joseph Saint Luc, Department of Urology, Lyon, 69007, France
| | - Alain Ruffion
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Department of Urology, Pierre-Bénite, 69310, France; Equipe 2 - Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY), Pierre-Bénite, 69310, France; Université de Lyon, Lyon, 69003, France; Université Lyon 1, Lyon, 69003, France; Faculté de Médecine Lyon Sud, Pierre-Bénite, 69310, France
| | - Marc Colombel
- Université de Lyon, Lyon, 69003, France; Université Lyon 1, Lyon, 69003, France; Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Urology, Lyon, 69003, France; Faculté de Médecine Lyon Est, Lyon, 69003, France
| | - Sébastien Crouzet
- INSERM, LabTAU, U1032, Lyon, 69003, France; Université de Lyon, Lyon, 69003, France; Université Lyon 1, Lyon, 69003, France; Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Urology, Lyon, 69003, France; Faculté de Médecine Lyon Est, Lyon, 69003, France
| | - Christelle Gonindard-Melodelima
- Université Grenoble Alpes, Laboratoire d'Ecologie Alpine, BP 53, Grenoble 38041, France; CNRS, UMR 5553, BP 53, Grenoble, 38041, France
| | - Olivier Rouvière
- INSERM, LabTAU, U1032, Lyon, 69003, France; Hospices Civils de Lyon, Hôpital Edouard Herriot, Department of Vascular and Urinary Imaging, Lyon, 69003, France; Université de Lyon, Lyon, 69003, France; Université Lyon 1, Lyon, 69003, France; Faculté de Médecine Lyon Est, Lyon, 69003, France.
| |
Collapse
|
3
|
Di Franco F, Souchon R, Crouzet S, Colombel M, Ruffion A, Klich A, Almeras M, Milot L, Rabilloud M, Rouvière O. Characterization of high-grade prostate cancer at multiparametric MRI: assessment of PI-RADS version 2.1 and version 2 descriptors across 21 readers with varying experience (MULTI study). Insights Imaging 2023; 14:49. [PMID: 36939970 PMCID: PMC10027981 DOI: 10.1186/s13244-023-01391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/21/2023] Open
Abstract
OBJECTIVE To assess PI-RADSv2.1 and PI-RADSv2 descriptors across readers with varying experience. METHODS Twenty-one radiologists (7 experienced (≥ 5 years) seniors, 7 less experienced seniors and 7 juniors) assessed 240 'predefined' lesions from 159 pre-biopsy multiparametric prostate MRIs. They specified their location (peripheral, transition or central zone) and size, and scored them using PI-RADSv2.1 and PI-RADSv2 descriptors. They also described and scored 'additional' lesions if needed. Per-lesion analysis assessed the 'predefined' lesions, using targeted biopsy as reference; per-lobe analysis included 'predefined' and 'additional' lesions, using combined systematic and targeted biopsy as reference. Areas under the curve (AUCs) quantified the performance in diagnosing clinically significant cancer (csPCa; ISUP ≥ 2 cancer). Kappa coefficients (κ) or concordance correlation coefficients (CCC) assessed inter-reader agreement. RESULTS At per-lesion analysis, inter-reader agreement on location and size was moderate-to-good (κ = 0.60-0.73) and excellent (CCC ≥ 0.80), respectively. Agreement on PI-RADSv2.1 scoring was moderate (κ = 0.43-0.47) for seniors and fair (κ = 0.39) for juniors. Using PI-RADSv2.1, juniors obtained a significantly lower AUC (0.74; 95% confidence interval [95%CI]: 0.70-0.79) than experienced seniors (0.80; 95%CI 0.76-0.84; p = 0.008) but not than less experienced seniors (0.74; 95%CI 0.70-0.78; p = 0.75). As compared to PI-RADSv2, PI-RADSv2.1 downgraded 17 lesions/reader (interquartile range [IQR]: 6-29), of which 2 (IQR: 1-3) were csPCa; it upgraded 4 lesions/reader (IQR: 2-7), of which 1 (IQR: 0-2) was csPCa. Per-lobe analysis, which included 60 (IQR: 25-73) 'additional' lesions/reader, yielded similar results. CONCLUSIONS Experience significantly impacted lesion characterization using PI-RADSv2.1 descriptors. As compared to PI-RADSv2, PI-RADSv2.1 tended to downgrade non-csPCa lesions, but this effect was small and variable across readers.
Collapse
Affiliation(s)
- Florian Di Franco
- Hospices Civils de Lyon, Department of Imaging, Hôpital Edouard Herriot, 69437, Lyon, France
| | | | - Sébastien Crouzet
- INSERM, LabTau, U1032, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
- Faculté de Médecine Lyon Est, Lyon, France
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, 69437, Lyon, France
| | - Marc Colombel
- Université de Lyon, Université Lyon 1, Lyon, France
- Faculté de Médecine Lyon Est, Lyon, France
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, 69437, Lyon, France
| | - Alain Ruffion
- Université de Lyon, Université Lyon 1, Lyon, France
- Hospices Civils de Lyon, Department of Urology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
- Equipe 2-Centre d'Innovation en Cancérologie de Lyon, 3738, Lyon, EA, France
- Faculté de Médecine Lyon Sud, 69003, Lyon, France
| | - Amna Klich
- Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Pôle Santé Publique, 69003, Lyon, France
- UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, CNRS, Équipe Biostatistique-Santé, 69100, Villeurbanne, France
| | - Mathilde Almeras
- Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Pôle Santé Publique, 69003, Lyon, France
- UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, CNRS, Équipe Biostatistique-Santé, 69100, Villeurbanne, France
| | - Laurent Milot
- Hospices Civils de Lyon, Department of Imaging, Hôpital Edouard Herriot, 69437, Lyon, France
- INSERM, LabTau, U1032, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
- Faculté de Médecine Lyon Sud, 69003, Lyon, France
| | - Muriel Rabilloud
- Université de Lyon, Université Lyon 1, Lyon, France
- Service de Biostatistique et Bioinformatique, Hospices Civils de Lyon, Pôle Santé Publique, 69003, Lyon, France
- UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, CNRS, Équipe Biostatistique-Santé, 69100, Villeurbanne, France
| | - Olivier Rouvière
- Hospices Civils de Lyon, Department of Imaging, Hôpital Edouard Herriot, 69437, Lyon, France.
- INSERM, LabTau, U1032, Lyon, France.
- Université de Lyon, Université Lyon 1, Lyon, France.
- Faculté de Médecine Lyon Est, Lyon, France.
| | | |
Collapse
|
4
|
Han C, Liu S, Qin XB, Ma S, Zhu LN, Wang XY. MRI combined with PSA density in detecting clinically significant prostate cancer in patients with PSA serum levels of 4∼10ng/mL: Biparametric versus multiparametric MRI. Diagn Interv Imaging 2020; 101:235-244. [PMID: 32063483 DOI: 10.1016/j.diii.2020.01.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/18/2020] [Accepted: 01/22/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To compare the performance of biparametric magnetic resonance imaging (bpMRI) to that of multiparametric MRI (mpMRI) in combination with prostate-specific antigen density (PSAD) in detecting clinically significant prostate cancer (csPCa) in patients with PSA serum levels of 4∼10ng/mL. MATERIALS AND METHODS A total of 123 men (mean age, 66.3±8.9 [SD]; range: 42-83 years) with PSA serum levels of 4∼10ng/mL with suspected csPCa were included. All patients underwent mpMRI at 3 Tesla and transrectal ultrasound-guided prostate biopsy in their clinical workup and were followed-up for >1 year when no csPCa was found at initial biopsy. The mpMRI images were reinterpreted according to the Prostate Imaging Reporting and Data System (PI-RADS, v2.1) twice in two different sessions using either mpMRI sequences or bpMRI sequences. The patients were divided into 2 groups according to whether csPCa was detected. The PI-RADS (mpMRI or bpMRI) categories and PSAD were used in combination to detect csPCa. Receiver operating characteristic (ROC) curve and decision curve analyses were performed to compare the efficacy of the different models (mpMRI, bpMRI, PSAD, mpMRI+PSAD and bpMRI+PSAD). RESULTS Thirty-seven patients (30.1%, 37/123) had csPCa. ROC analysis showed that bpMRI (AUC=0.884 [95% confidence interval (CI): 0.814-0.935]) outperformed mpMRI (AUC=0.867 [95% CI: 0.794-0.921]) (P=0.035) and that bpMRI and mpMRI performed better than PSAD (0.682 [95% CI: 0.592-0.763]) in detecting csPCa; bpMRI+PSAD (AUC=0.907 [95% CI: 0.841-0.952]) performed similarly to mpMRI+PSAD (AUC=0.896 [95% CI: 0.828-0.944]) (P=0.151) and bpMRI (P=0.224). The sensitivity and specificity were 81.1% (95% CI: 64.8-92.0%) and 88.4% (95% CI: 79.7-94.3%), respectively for bpMRI, and 83.8% (95% CI: 68.0-93.8%) and 80.2% (95% CI: 70.2-88.0%), respectively for mpMRI (P>0.999 for sensitivity and P=0.016 for specificity). Among the 5 decision models, the decision curve analysis showed that all models (except for PSAD) achieved a high net benefit. CONCLUSION In patients with PSA serum levels of 4∼10ng/mL, bpMRI and bpMRI combined with PSAD achieve better performance than mpMRI in detecting csPCa; bpMRI has a higher specificity than mpMRI, which could decrease unnecessary biopsy, and may serve as a potential alternative to mpMRI to optimize clinical workup.
Collapse
Affiliation(s)
- C Han
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China
| | - S Liu
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China
| | - X B Qin
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China
| | - S Ma
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China
| | - L N Zhu
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China
| | - X Y Wang
- Department of Radiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, 100034 Beijing, China.
| |
Collapse
|
5
|
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]
|
6
|
Wu X, Reinikainen P, Kapanen M, Vierikko T, Ryymin P, Kellokumpu-Lehtinen PL. Monitoring radiotherapy induced tissue changes in localized prostate cancer by multi-parametric magnetic resonance imaging (MP-MRI). Diagn Interv Imaging 2019; 100:699-708. [DOI: 10.1016/j.diii.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 01/11/2023]
|
7
|
Deborde E, Dubourg B, Bejar S, Brehin AC, Normant S, Michelin P, Dacher JN. Differentiation between Fabry disease and hypertrophic cardiomyopathy with cardiac T1 mapping. Diagn Interv Imaging 2019; 101:59-67. [PMID: 31519470 DOI: 10.1016/j.diii.2019.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/03/2019] [Accepted: 08/27/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate the potential of non-contrast myocardial T1 mapping on cardiovascular magnetic resonance examination (CMR) in differentiating patients with Fabry disease (FD) from those with hypertrophic cardiomyopathy (HCM) and healthy control subjects. MATERIALS AND METHODS Seventeen patients with FD (8 men, 9 women; mean age, 48 ±18 [SD] years; [range: 19-73 years]; 53% with left ventricular hypertrophy [LVH]) were matched with 36 patients with hypertrophic cardiomyopathy (HCM) (22 men, 14 women; mean age, 57±16 [SD] years; [range: 22-85 years]) and 70 healthy control subjects (34 men, 36 women; mean age, 38 ±15 [SD] years; [range: 18-65 years]). Cardiac T1 mapping was performed using the modified Look-Locker inversion (MOLLI®) sequence on a 1.5-T magnet. T1 values were calculated, on midventricular section, for septal left ventricular segments (S8-S9) and all mid-ventricular ones (global T1 values; S7-S12). Statistical analysis included unpaired Mann-Whitney test, receiver operating characteristic curve and likelihood ratios. RESULTS Septal native T1 values were significantly decreased in patients with FD (889±61 [SD] ms; range: 784-980ms) compared to those with HCM (995±48 [SD] ms; range: 935-1125ms) (P<0.001) and versus healthy controls (965±29 [SD] ms; range: 910-1028ms) (P<0.001). Global native T1 values were also significantly decreased in patients with FD (891±49 [SD] ms; range 794-970ms) compared to those with HCM (995±34 [SD] ms; range: 952-1086ms) (P<0.001) and versus healthy controls (966±27 [SD] ms; range: 920-1042ms) (P<0.001). A septal left ventricular native T1 cutoff value of 940ms could distinguish FD from HCM with 88% sensitivity (95% CI: 73-100%) and 92% specificity (95% CI: 83-100%). Positive likelihood ratio was 11, negative likelihood ratio was 0.12. Compared to controls, the same threshold could distinguish FD with 88% sensitivity (95% CI: 73-100%) and 86% specificity (95% CI: 78-94%). Positive likelihood ratio was 6.3, negative likelihood ratio was 0.14. T1 value was abnormal in 4 of 8 (50%) of FD patients who did not have LVH. CONCLUSION Native T1 values are significantly lower in patients with FD by comparison with those with HCM and healthy volunteers.
Collapse
Affiliation(s)
- E Deborde
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; Department of Radiology, University Hospital of Strasbourg, 67098 Strasbourg, France.
| | - B Dubourg
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
| | - S Bejar
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - A-C Brehin
- Department of Genetics, University Hospital of Rouen, 76031 Rouen, France
| | - S Normant
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - P Michelin
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France
| | - J-N Dacher
- Department of Radiology, University Hospital of Rouen, 76031 Rouen, France; INSERM U1096, UFR Médecine Pharmacie, 76183 Rouen, France; Institute for Research and Innovation in Biomedicine, University of Rouen, 76000 Rouen, France
| |
Collapse
|