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Validating multiparametric MRI for diagnosis and monitoring of prostate cancer in patients for active surveillance.

Abstract：

PURPOSE:To compare multiparametric magnetic resonance imaging (mpMRI) with transrectal ultrasound-guided prostate biopsy (TRUS-bx) for the diagnosis and monitoring of small-volume prostate cancer (PCa) in patients on active surveillance (AS). METHODS:In a retrospective cross-sectional validation study, 100 patients on AS for PCa underwent a systematic 12-core TRUS-bx (the gold standard) as well as mpMRI, on either a 1.5 or 3 Tesla scanner (32 and 68 patients, respectively). Three pathologists reported biopsy histology separately. A single, experienced radiologist scored mpMRI scans using the PI-RADS system. We compared left- and right-sided PI-RADS scores of the peripheral zone with TRUS-bx results of the relevant prostate lobe. We then estimated the specificity and sensitivity of mpMRI in diagnosing low-grade low-risk PCa in our AS cohort. RESULTS:The sensitivity of mpMRI was 37% (95% CI 28-47%) and specificity was 85% (CI 76-92%) for cancer. The negative predictive value was 51% (CI 44-60%), and the positive predictive value was 76% (CI 62-87%). The positive and negative likelihood ratios were 2.5 and 0.7, respectively. CONCLUSION:Because of its low specificity and low negative predictive value, mpMRI is not suitable for diagnosing low-grade small-volume PCa. However, because of a specificity of 85% and a negative likelihood ratio of 0.7, mpMRI may be useful for follow-up of previously TRUS-bx diagnosed patients who are on AS.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Sahibzada I,Batura D,Hellawell G

doi

10.1007/s11255-016-1212-4

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

529-33

issue

4

eissn

0301-1623

issn

1573-2584

pii

10.1007/s11255-016-1212-4

journal_volume

48

pub_type

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