Aim of the Study: We aimed to compare the diagnostic accuracy of three Tesla BiparametricMagnetic Resonance Imaging (bpMRI) of the prostate, Prostate Specific Antigen Density (PSA-D) and their combination for the detection of clinically significant Prostate Cancer (PCa). Materials and Methods: We performed a retrospective study. Patients with clinical suspicion of PCa and PSA value between 2.5 and 10 ng/dL who underwent three Tesla bpMRI and subsequent prostate biopsy in a single institution were included into the study. Patients with history of previous prostate biopsy were excluded. PSA-D value was calculated based on prostate volume obtained during bpMRI. PCa lesions with an International Society of Urological Pathology (ISUP) score = or >3 were considered clinically significant PCa. Sensitivity and specificity in detecting clinically significant PCa were determined for bpMRI, PSA-D, and their combination. Receiver operating characteristic (ROC) curves were calculated. A p < 0.05 was considered statistically significant. Results: A total of 114 patients who underwent bpMRI and prostate biopsy between January 2015 and September 2017 were included into the study. bpMRI imaging consisted of T2-weighted imaging and diffusion weighted imaging acquisitions (b-values 0, 400, 1500) and was evaluated with a Likert score based on PI-RADS v2. All patients received 16-core transrectal prostate biopsy by a single operator. The sensitivity of bpMRI ad PSA-D in detecting clinically significant PCawas 93% and 77%, respectively (p < 0.005). ROC curves analysis showed that area under the curve (AUC) of bpMRI, PSA-D and combinationwas 0.87, 0.79 and 0.91, respectively (Figure 1). Based on the results of ROC curves, combination showed no significant improvement versus bpMRI alone. Discussion: bpMRI has a greater sensitivity and similar specificity compared to the PSA-D in the detection of clinically significant PCa. bpMRI combined with PSA-D does not provide superior results compared to bpMR alone. Our analysis suggests a possible independent role for bpMRI in the detection of clinically significant PCa.

Diagnostic accuracy of three tesla biparametric magnetic resonance imaging of the prostate, prostate specific antigen density and their combination for the detection of clinically significant prostate cancer: Results from a retrospective study

F. Persico;N. Longo;F. Fusco;M. Creta;G. Califano;R. La Rocca;F. Mangiapia;A. Stanzione;M. Imbriaco;V. Mirone
2018

Abstract

Aim of the Study: We aimed to compare the diagnostic accuracy of three Tesla BiparametricMagnetic Resonance Imaging (bpMRI) of the prostate, Prostate Specific Antigen Density (PSA-D) and their combination for the detection of clinically significant Prostate Cancer (PCa). Materials and Methods: We performed a retrospective study. Patients with clinical suspicion of PCa and PSA value between 2.5 and 10 ng/dL who underwent three Tesla bpMRI and subsequent prostate biopsy in a single institution were included into the study. Patients with history of previous prostate biopsy were excluded. PSA-D value was calculated based on prostate volume obtained during bpMRI. PCa lesions with an International Society of Urological Pathology (ISUP) score = or >3 were considered clinically significant PCa. Sensitivity and specificity in detecting clinically significant PCa were determined for bpMRI, PSA-D, and their combination. Receiver operating characteristic (ROC) curves were calculated. A p < 0.05 was considered statistically significant. Results: A total of 114 patients who underwent bpMRI and prostate biopsy between January 2015 and September 2017 were included into the study. bpMRI imaging consisted of T2-weighted imaging and diffusion weighted imaging acquisitions (b-values 0, 400, 1500) and was evaluated with a Likert score based on PI-RADS v2. All patients received 16-core transrectal prostate biopsy by a single operator. The sensitivity of bpMRI ad PSA-D in detecting clinically significant PCawas 93% and 77%, respectively (p < 0.005). ROC curves analysis showed that area under the curve (AUC) of bpMRI, PSA-D and combinationwas 0.87, 0.79 and 0.91, respectively (Figure 1). Based on the results of ROC curves, combination showed no significant improvement versus bpMRI alone. Discussion: bpMRI has a greater sensitivity and similar specificity compared to the PSA-D in the detection of clinically significant PCa. bpMRI combined with PSA-D does not provide superior results compared to bpMR alone. Our analysis suggests a possible independent role for bpMRI in the detection of clinically significant PCa.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/723775
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