Prediction of Clinically Significant Prostate Cancer Using Multiparametric MRI, Biparametric MRI, and Clinical Parameters.

Oberneder, Maximilian; Henzler, Thomas; Kriegmair, Martin; Vag, Tibor; Roethke, Matthias; Siegert, Sabine; Lang, Roland; Lenk, Julia; Gawlitza, Joshua

doi:10.1159/000541152

Clinical Medicine

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Title:: Prediction of Clinically Significant Prostate Cancer Using Multiparametric MRI, Biparametric MRI, and Clinical Parameters.
Document type:: Journal Article
Author(s):: Oberneder, Maximilian; Henzler, Thomas; Kriegmair, Martin; Vag, Tibor; Roethke, Matthias; Siegert, Sabine; Lang, Roland; Lenk, Julia; Gawlitza, Joshua
Abstract:: INTRODUCTION: Multiparametric MRI (mpMRI) is gold standard for the primary diagnostic work-up of clinically significant prostate cancer (csPCa). The aim of this study was to assess the benefit of the perfusion sequence and the non-inferiority of an MRI without contrast administration (bpMRI) compared to mpMRI while taking clinical parameters into account. METHODS: In this retrospective, non-interventional study we examined MRI data from 355 biopsy-naïve patients, performed on a 3T MRI system, evaluated by a board-certified radiologist with over 10 years of experience with subsequent mpMRI-TRUS fusion biopsy. DISCUSSION: Only 16/355 (4.5%) patients benefited from dynamic contrast enhanced. In only 3/355 (0.8%) patients, csPCa would have been missed in bpMRI. BpMRI provided sensitivity and specificity (81.4%; 79.4%) comparable to mpMRI (75.2%; 81.8%). Additionally, bpMRI and mpMRI were independent predictors for the presence of csPCa, individually (OR: 15.36; p < 0.001 vs. 12.15; p = 0.006) and after accounting for established influencing factors (OR: 12.81; p < 0.001 vs. 6.50; p = 0.012). When clinical parameters were considered, a more balanced diagnostic performance between sensitivity and specificity was found for mpMRI and bpMRI. Overall, PSA density showed the highest diagnostic performance (area under the curve = 0.81) for the detection of csPCa. CONCLUSION: The premise of the study was confirmed. Therefore, bpMRI should be adopted as soon as existing limitations have been lifted by prospective multi-reader studies.
Journal title abbreviation:: Urol Int
Year:: 2024
Pages contribution:: 1-8
Fulltext / DOI:: doi:10.1159/000541152
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/39217986
Print-ISSN:: 0042-1138
TUM Institution:: Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)
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mediaTUM Gesamtbestand Hochschulbibliographie 2024 Schools und Fakultäten TUM School of Medicine and Health Institut für Radiologie

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)2024