The accuracy of multiparametric MRI in men with negative biopsy and elevated PSA level-Can it rule out clinically significant prostate cancer?

被引:34
作者
Abd-Alazeez, Mohamed [1 ,2 ]
Ahmed, Hashim U. [1 ,3 ]
Arya, Manit [1 ,4 ]
Charman, Susan C. [5 ]
Anastasiadis, Eleni [6 ]
Freeman, Alex [7 ]
Emberton, Mark [1 ,3 ]
Kirkham, Alex [8 ]
机构
[1] Univ Coll London Hosp NHS Fdn Trust, Dept Urol, London, England
[2] Fayoum Univ, Dept Urol, Fac Med, Al Fayyum, Egypt
[3] UCL, Div Surg & Intervent Sci, London, England
[4] Univ London, Barts Canc Inst, London, England
[5] London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London WC1, England
[6] Royal Coll Surgeons England, Clin Effectiveness Unit, London WC2A 3PN, England
[7] Univ Coll Hosp NHS Fdn Trust, Dept Histopathol, London, England
[8] Univ Coll Hosp NHS Fdn Trust, Dept Radiol, London, England
基金
英国医学研究理事会;
关键词
Clinically significant disease; Multiparametric MRI; negative biopsy; Template prostate mapping; SATURATION BIOPSY; MAPPING BIOPSY; TRANSPERINEAL; VALIDATION; SOCIETY; COHORT; TUMORS;
D O I
10.1016/j.urolonc.2013.06.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To assess the performance of multiparametric magnetic resonance imaging (mp-MR1) in patients with previous negative transrectal ultrasound (TRUS) guided prostate biopsy. Materials and methods: Fifty-four patients with at least 1 previous negative TRUS prostate biopsy underwent mp-MR1 in the form of T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging. This was followed by transperineal template systematic prostate biopsies. Analysis was done based on 2 sectors per prostate, right and left (108 sectors out of 54 prostates). mp-MRI was scored using an ordinal scale 1 to 5 based on the suspicion of the presence of clinically significant disease. We used 6 different definitions for clinically significant disease and tested the performance of mp-MRI at each single definition. Results: Median age was 64 (range, 39-75), median PSA level was 10 (range, 2-23), and median number of biopsies was 45 (range, 21-137). Cancer of any volume and any grade was detected in 34 of 54 (63%) patients. mp-MRI accuracy at detection of clinically significant cancer using University College London (UCL) definition 2 (any Gleason score of 4 or maximum cancer core length of >4 mm or both) showed sensitivity of 76%, specificity of 42%, positive predictive value of 38%, and negative predictive value of 79%. For a different definition of significant tumor (1/CL, definition 1, dominant Gleason score 4 or maximum cancer core length >6 mm or both), the sensitivity was 90%, specificity 42%, positive predictive value 26%, and negative predictive value 95%. Conclusions: mp-MR1 showed good performance at both detection and ruling out clinically significant disease, according to the definition used nip-MR1 can then be used as a triage test in the population with persistently elevated or rising PSA levels to select patients that can avoid unnecessary prostate biopsy. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:45.e17 / 45.e22
页数:6
相关论文
共 19 条
[1]   Characterizing Clinically Significant Prostate Cancer Using Template Prostate Mapping Biopsy [J].
Ahmed, Hashim Uddin ;
Hu, Yipeng ;
Carter, Tim ;
Arumainayagam, Nimalan ;
Lecornet, Emilie ;
Freeman, Alex ;
Hawkes, David ;
Barratt, Dean C. ;
Emberton, Mark .
JOURNAL OF UROLOGY, 2011, 186 (02) :458-464
[2]   Multiparametric MR Imaging for Detection of Clinically Significant Prostate Cancer: A Validation Cohort Study with Transperineal Template Prostate Mapping as the Reference Standard [J].
Arumainayagam, Nimalan ;
Ahmed, Hashim U. ;
Moore, Caroline M. ;
Freeman, Alex ;
Allen, Clare ;
Sohaib, S. Aslam ;
Kirkham, Alex ;
van der Meulen, Jan ;
Emberton, Mark .
RADIOLOGY, 2013, 268 (03) :761-769
[3]   ESUR prostate MR guidelines 2012 [J].
Barentsz, Jelle O. ;
Richenberg, Jonathan ;
Clements, Richard ;
Choyke, Peter ;
Verma, Sadhna ;
Villeirs, Geert ;
Rouviere, Olivier ;
Logager, Vibeke ;
Futterer, Jurgen J. .
EUROPEAN RADIOLOGY, 2012, 22 (04) :746-757
[4]   Appropriate patient selection in the focal treatment of prostate cancer: The role of transperineal 3-dimensional pathologic mapping of the prostate - A 4-year experience [J].
Barzell, Winston E. ;
Melamed, Myron R. .
UROLOGY, 2007, 70 (6A) :27-35
[5]   Characteristics of insignificant clinical T1c prostate tumors - A contemporary analysis [J].
Bastian, PJ ;
Mangold, LA ;
Epstein, JI ;
Partin, AW .
CANCER, 2004, 101 (09) :2001-2005
[6]   Incidence and Pathological Features of Prostate Cancer Detected on Transperineal Template Guided Mapping Biopsy After Negative Transrectal Ultrasound Guided Biopsy [J].
Bittner, Nathan ;
Merrick, Gregory S. ;
Butler, Wayne M. ;
Bennett, Abbey ;
Galbreath, Robert W. .
JOURNAL OF UROLOGY, 2013, 190 (02) :509-514
[7]   Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: When should we stop? [J].
Djavan, B ;
Ravery, V ;
Zlotta, A ;
Dobronski, P ;
Dobrovits, M ;
Fakhari, M ;
Seitz, C ;
Susani, M ;
Borkowski, A ;
Boccon-Gibod, L ;
Schulman, CC ;
Marberger, M .
JOURNAL OF UROLOGY, 2001, 166 (05) :1679-1683
[8]   The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma [J].
Epstein, JI ;
Allsbrook, WC ;
Amin, MB ;
Egevad, LL ;
Bastacky, S ;
Beltrán, AL ;
Berner, A ;
Billis, A ;
Boccon-Gibod, L ;
Cheng, L ;
Civantos, F ;
Cohen, C ;
Cohen, MB ;
Datta, M ;
Davis, C ;
Delahunt, B ;
Delprado, W ;
Eble, JN ;
Foster, CS ;
Furusato, M ;
Gaudin, PB ;
Grignon, DJ ;
Humphrey, PA ;
Iczkowski, KA ;
Jones, EC ;
Lucia, S ;
McCue, PA ;
Nazeer, T ;
Oliva, E ;
Pan, CC ;
Pizov, G ;
Reuter, V ;
Samaratunga, H ;
Sebo, T ;
Sesterhenn, I ;
Shevchuk, M ;
Srigley, JR ;
Suzigan, S ;
Takahashi, H ;
Tamboli, P ;
Tan, PH ;
Têtu, B ;
Tickoo, S ;
Tomaszewski, JE ;
Troncoso, P ;
Tsuzuki, T ;
True, LD ;
van der Kwast, T ;
Wheeler, TM ;
Wojno, KJ .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2005, 29 (09) :1228-1242
[9]   PATHOLOGICAL AND CLINICAL FINDINGS TO PREDICT TUMOR EXTENT OF NONPALPABLE (STAGE-T1C) PROSTATE-CANCER [J].
EPSTEIN, JI ;
WALSH, PC ;
CARMICHAEL, M ;
BRENDLER, CB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (05) :368-374
[10]   Areas Suspicious for Prostate Cancer: MR-guided Biopsy in Patients with at Least One Transrectal US-guided Biopsy with a Negative Finding-Multiparametric MR Imaging for Detection and Biopsy Planning [J].
Franiel, Tobias ;
Stephan, Carsten ;
Erbersdobler, Andreas ;
Dietz, Ekkehart ;
Maxeiner, Andreas ;
Hell, Nina ;
Huppertz, Alexander ;
Miller, Kurt ;
Strecker, Ralph ;
Hamm, Bernd .
RADIOLOGY, 2011, 259 (01) :162-172