Purpose: Bi-parametric prostate MR (bp-MR) is a valuable tool for detection and characterization of prostate cancer (PCa). Recent studies suggested that PSA-density (PSA-D) in combination with multi-parametric prostate MR as well as bp-MR may achieve a higher diagnostic accuracy than either alone. We aimed to evaluate the diagnostic performance of bp-MR, PSA-D and their combination in biopsy-naïve patients. Methods and materials: We retrospectively analyzed 334 consecutive patients who underwent prostate MR on a 3T scanner. Only patients (n = 114) who underwent TRUS-biopsy within 30 days following MR with no previous prostate biopsies were considered. Our protocol included T2-weighted and DWI sequences. A Likert score based on PI-RADS v2 was used for bp-MR evaluation. Lesions were graded histopathologically using the ISUP score. We assessed three scenarios: detection of lesions independently of ISUP score (ISUP ≥ 1), detection of both intermediate and clinically significant lesions (ISUP ≥ 2) and detection of clinically significant lesions alone (ISUP ≥ 3). Predictive value of bp-MR and PSA-D was evaluated by ROC curves and logistic regression analysis. A p value < 0.05 was considered statistically significant. Results: In all evaluated scenarios, bp-MR showed a significantly higher predictive power (AUC = 0.87-0.95) compared to the performance of PSA-D (AUC = 0.73-0.79), while their combination (AUC = 0.91-0.95) showed no statistically significant improvement compared to bp-MR alone. Conclusion: Our results confirm that bp-MR is a powerful tool in detection of clinically significant PCa. Contrary to findings in the recent literature, PSA-D does not appear to significantly improve its diagnostic performance.

PSA-density does not improve bi-parametric prostate MR detection of prostate cancer in a biopsy naïve patient population / Cuocolo, Renato; Stanzione, Arnaldo; Rusconi, Giovanni; Petretta, Mario; Ponsiglione, Andrea; Fusco, Ferdinando; Longo, Nicola; Persico, Francesco; Cocozza, Sirio; Brunetti, Arturo; Imbriaco, Massimo. - In: EUROPEAN JOURNAL OF RADIOLOGY. - ISSN 0720-048X. - 104:(2018), pp. 64-70. [10.1016/j.ejrad.2018.05.004]

PSA-density does not improve bi-parametric prostate MR detection of prostate cancer in a biopsy naïve patient population

Cuocolo, Renato;STANZIONE, ARNALDO;RUSCONI, GIOVANNI;Petretta, Mario
Writing – Review & Editing
;
Ponsiglione, Andrea;Longo, Nicola;Cocozza, Sirio;Brunetti, Arturo;Imbriaco, Massimo
2018

Abstract

Purpose: Bi-parametric prostate MR (bp-MR) is a valuable tool for detection and characterization of prostate cancer (PCa). Recent studies suggested that PSA-density (PSA-D) in combination with multi-parametric prostate MR as well as bp-MR may achieve a higher diagnostic accuracy than either alone. We aimed to evaluate the diagnostic performance of bp-MR, PSA-D and their combination in biopsy-naïve patients. Methods and materials: We retrospectively analyzed 334 consecutive patients who underwent prostate MR on a 3T scanner. Only patients (n = 114) who underwent TRUS-biopsy within 30 days following MR with no previous prostate biopsies were considered. Our protocol included T2-weighted and DWI sequences. A Likert score based on PI-RADS v2 was used for bp-MR evaluation. Lesions were graded histopathologically using the ISUP score. We assessed three scenarios: detection of lesions independently of ISUP score (ISUP ≥ 1), detection of both intermediate and clinically significant lesions (ISUP ≥ 2) and detection of clinically significant lesions alone (ISUP ≥ 3). Predictive value of bp-MR and PSA-D was evaluated by ROC curves and logistic regression analysis. A p value < 0.05 was considered statistically significant. Results: In all evaluated scenarios, bp-MR showed a significantly higher predictive power (AUC = 0.87-0.95) compared to the performance of PSA-D (AUC = 0.73-0.79), while their combination (AUC = 0.91-0.95) showed no statistically significant improvement compared to bp-MR alone. Conclusion: Our results confirm that bp-MR is a powerful tool in detection of clinically significant PCa. Contrary to findings in the recent literature, PSA-D does not appear to significantly improve its diagnostic performance.
2018
PSA-density does not improve bi-parametric prostate MR detection of prostate cancer in a biopsy naïve patient population / Cuocolo, Renato; Stanzione, Arnaldo; Rusconi, Giovanni; Petretta, Mario; Ponsiglione, Andrea; Fusco, Ferdinando; Longo, Nicola; Persico, Francesco; Cocozza, Sirio; Brunetti, Arturo; Imbriaco, Massimo. - In: EUROPEAN JOURNAL OF RADIOLOGY. - ISSN 0720-048X. - 104:(2018), pp. 64-70. [10.1016/j.ejrad.2018.05.004]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/718044
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