OBJECTIVE: The objective of our study was to determine the accuracy of endorectal MRI and MR spectroscopic imaging (MRSI) in the diagnosis of prostate cancer in patients with an elevated serum prostate-specific antigen (PSA) level. MATERIALS AND METHODS: We retrospectively identified 40 patients with an elevated serum PSA level and without a histologic diagnosis of prostate cancer who underwent endorectal MRI and MRSI at our institution. On the basis of MRI findings alone and then combined MRI and MRSI findings, a single experienced observer rated the presence or absence of prostate cancer in each side of the prostate on a 5-point scale (1 = definitely absent, 5 = definitely present). Areas under the receiver operating characteristic (ROC) curve were calculated using the hemiprostate as the unit of analysis. The presence or absence of cancer on subsequent endorectal sonographically guided sextant biopsy was used as the standard of reference. RESULTS: Biopsy revealed no cancer in 24 patients, bilateral cancer in 11, and unilateral cancer in five. The areas under the ROC curve for the diagnosis of prostate cancer by hemigland was 0.70 for MRI alone and 0.63 for combined MRI and MRSI (no significant difference, p = 0.32). CONCLUSION: Endorectal MRI and MRSI are reasonably accurate for the diagnosis of prostate cancer in patients with an elevated serum PSA level, but the remaining limitations suggest that MRI and MRSI should be used as a supplement rather than a replacement for biopsy using the current technology and diagnostic criteria.
OBJECTIVE: The objective of our study was to determine the accuracy of endorectal MRI and MR spectroscopic imaging (MRSI) in the diagnosis of prostate cancer in patients with an elevated serum prostate-specific antigen (PSA) level. MATERIALS AND METHODS: We retrospectively identified 40 patients with an elevated serum PSA level and without a histologic diagnosis of prostate cancer who underwent endorectal MRI and MRSI at our institution. On the basis of MRI findings alone and then combined MRI and MRSI findings, a single experienced observer rated the presence or absence of prostate cancer in each side of the prostate on a 5-point scale (1 = definitely absent, 5 = definitely present). Areas under the receiver operating characteristic (ROC) curve were calculated using the hemiprostate as the unit of analysis. The presence or absence of cancer on subsequent endorectal sonographically guided sextant biopsy was used as the standard of reference. RESULTS: Biopsy revealed no cancer in 24 patients, bilateral cancer in 11, and unilateral cancer in five. The areas under the ROC curve for the diagnosis of prostate cancer by hemigland was 0.70 for MRI alone and 0.63 for combined MRI and MRSI (no significant difference, p = 0.32). CONCLUSION: Endorectal MRI and MRSI are reasonably accurate for the diagnosis of prostate cancer in patients with an elevated serum PSA level, but the remaining limitations suggest that MRI and MRSI should be used as a supplement rather than a replacement for biopsy using the current technology and diagnostic criteria.
Authors: Raisa Z Freidlin; Harsh K Agarwal; Sandeep Sankineni; Anna M Brown; Francesca Mertan; Marcelino Bernardo; Dagane Daar; Maria Merino; Deborah Citrin; Bradford J Wood; Peter A Pinto; Peter L Choyke; Baris Turkbey Journal: Magn Reson Imaging Date: 2016-07-20 Impact factor: 2.546
Authors: Myung Sun Choi; Yong Sun Choi; Byung Il Yoon; Su Jin Kim; Hyuk Jin Cho; Sung Hoo Hong; Ji Youl Lee; Tae-Kon Hwang; Sae Woong Kim Journal: Korean J Urol Date: 2011-08-22
Authors: Martin Umbehr; Lucas M Bachmann; Ulrike Held; Thomas M Kessler; Tullio Sulser; Dominik Weishaupt; John Kurhanewicz; Johann Steurer Journal: Eur Urol Date: 2008-10-18 Impact factor: 20.096