Efficacy of 3T Multiparametric MR Imaging followed by 3T in-Bore MR-Guided Biopsy for Detection of Clinically Significant Prostate Cancer Based on PIRADSv2.1 Score |
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| Institution: | 1. Department of Radiology, Ronald Reagan-University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California;2. Department of Urology, Ronald Reagan-University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California;3. Department of Bioinformatics, University of California Los Angeles Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California;1. Department of Radiology, Division of Interventional Radiology, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ, 85724;2. Department of Radiology, Section of Interventional Radiology, University of Chicago Medicine, Chicago, Illinois;1. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 646 BRB II/III, 421 Curie Blvd., Philadelphia, PA 19104;2. Medivis, Brooklyn, New York;1. Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr B1D502, Ann Arbor, MI 48109-5030;2. Division of Vascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, Stanford, California;3. Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio;1. Department of Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg 93053, Germany;2. Department of Radiology, Hospital Donaustauf, Donaustauf, Germany;1. Department of Radiology and Biomedical Imaging, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510;2. Department of Biomedical Engineering, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510;3. Department of Cardiology, Yale Translational Research Imaging Center, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510;4. Institute of Radiology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany;5. PreScience Labs, Westport, Connecticut;6. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands |
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| Abstract: | PurposeTo evaluate the diagnostic yield of 3T in-Bore magnetic resonance-guided biopsy (3T IB-MRGB) for detection of clinically significant prostate cancer (csPCa), based on assessment using the Prostate Imaging Reporting and Data System version 2.1 (PIRADSv2.1).Materials and MethodsThis single-center study examined individuals who underwent 3T multiparametric prostate magnetic resonance (MR) imaging and subsequent 3T IB-MRGB. The final study cohort included 379 men (with 475 targets) divided into 3 subcohorts: biopsy-naïve men (n = 123), individuals with a history of negative trans-rectal-ultrasonography (TRUS) biopsy results (n = 106), and men with low-grade PCa under active surveillance (n = 150). csPCa was defined as having a Gleason score (GS) ≥3+4.Results3T IB-MRGB detected PCa and csPCa in 69.1% (262 of 379) and 50.3% (193 of 379) of patients, respectively. The PCa and csPCa detection rates per target were 64.2% (305 of 475) and 43.8% (208 of 475), respectively. The rate of urosepsis, treated with intravenous antibiotics, was 1% (4 patients). In TRUS biopsy negative results and biopsy-naïve subcohorts, csPCa was found in 36.8% (39 of 106) and 52.8% (65 of 123), respectively. In 50.7% (76 of 150) of the active surveillance subcohort, 3T IB-MRGB upgraded the GS assigned in prior TRUS biopsies. Positive predictive values of PIRADSv2.1 categories 3, 4, and 5 for csPCa detection were 24.8%, 44.4%, and 67.1%, respectively. Higher PIRADSv2.1 categories were significantly associated with PCa (odds ratio OR], 3.97; 95% confidence interval CI], 2.98–5.28) and csPCa (OR, 1.41; 95% CI, 1.03–1.94) detection. Of 137 PIRADSv2 category 3 lesions, 28 were downgraded to PIRADSv2.1 category 2, in which there were no occurrences of csPCa in histology.ConclusionsUse of 3T IB-MRGB resulted in detection of csPCa in 50.9% of individuals. 3T IB-MRGB has a high diagnostic yield in individuals with negative TRUS biopsy results and those under active surveillance. The PIRADSv2.1 category is a strong predictor of PCa and csPCa detection. |
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