OBJECTIVE: To evaluate whether focal abnormalities (FAs) depicted by prostate MRI could be characterised using simple semiological features. METHODS: 134 patients who underwent T2-weighted, diffusion-weighted and dynamic contrast-enhanced MRI at 1.5 T before prostate biopsy were prospectively included. FAs visible at MRI were characterised by their shape, the degree of signal abnormality (0 = normal to 3 = markedly abnormal) on individual MR sequences, and a subjective score (SS(1) = probably benign to SS(3) = probably malignant). FAs were then biopsied under US guidance. RESULTS: 56/233 FAs were positive at biopsy. The subjective score significantly predicted biopsy results (P < 0.01). As compared to SS(1) FAs, the odds ratios (OR) of malignancy of SS(2) and SS(3) FAs were 9.9 (1.8-55.9) and 163.8 (11.5-2331). Unlike FAs' shape, a simple combination of MR signal abnormalities (into "low-risk", "intermediate" and "high-risk" groups) significantly predicted biopsy results (P < 0.008). As compared to "low risk" FAs, the OR of malignancy of "intermediate" and "high-risk" FAs were 4.5 (1.1-18.4) and 52.7 (6.8-407) in the overall population and 5.4 (1.1-27.2) and 118.2 (6.1-2301) in PZ. CONCLUSIONS: A simple combination of signal abnormalities of individual MR sequences can significantly stratify the risk of malignancy of FAs, holding promise of a more standardised interpretation of MRI by readers with varying experience. KEY POINTS: • Using multiparameter(mp)-MRI, experienced uroradiologists can stratify the malignancy risk of prostatic lesions • The shape of prostatic focal abnormalities in the peripheral zone does not help predicting malignancy. • A simple combination of findings at mp-MRI can help less-experienced radiologists.
OBJECTIVE: To evaluate whether focal abnormalities (FAs) depicted by prostate MRI could be characterised using simple semiological features. METHODS: 134 patients who underwent T2-weighted, diffusion-weighted and dynamic contrast-enhanced MRI at 1.5 T before prostate biopsy were prospectively included. FAs visible at MRI were characterised by their shape, the degree of signal abnormality (0 = normal to 3 = markedly abnormal) on individual MR sequences, and a subjective score (SS(1) = probably benign to SS(3) = probably malignant). FAs were then biopsied under US guidance. RESULTS: 56/233 FAs were positive at biopsy. The subjective score significantly predicted biopsy results (P < 0.01). As compared to SS(1) FAs, the odds ratios (OR) of malignancy of SS(2) and SS(3) FAs were 9.9 (1.8-55.9) and 163.8 (11.5-2331). Unlike FAs' shape, a simple combination of MR signal abnormalities (into "low-risk", "intermediate" and "high-risk" groups) significantly predicted biopsy results (P < 0.008). As compared to "low risk" FAs, the OR of malignancy of "intermediate" and "high-risk" FAs were 4.5 (1.1-18.4) and 52.7 (6.8-407) in the overall population and 5.4 (1.1-27.2) and 118.2 (6.1-2301) in PZ. CONCLUSIONS: A simple combination of signal abnormalities of individual MR sequences can significantly stratify the risk of malignancy of FAs, holding promise of a more standardised interpretation of MRI by readers with varying experience. KEY POINTS: • Using multiparameter(mp)-MRI, experienced uroradiologists can stratify the malignancy risk of prostatic lesions • The shape of prostatic focal abnormalities in the peripheral zone does not help predicting malignancy. • A simple combination of findings at mp-MRI can help less-experienced radiologists.
Authors: Peter A Pinto; Paul H Chung; Ardeshir R Rastinehad; Angelo A Baccala; Jochen Kruecker; Compton J Benjamin; Sheng Xu; Pingkun Yan; Samuel Kadoury; Celene Chua; Julia K Locklin; Baris Turkbey; Joanna H Shih; Stacey P Gates; Carey Buckner; Gennady Bratslavsky; W Marston Linehan; Neil D Glossop; Peter L Choyke; Bradford J Wood Journal: J Urol Date: 2011-08-17 Impact factor: 7.450
Authors: G J Jager; E T Ruijter; C A van de Kaa; J J de la Rosette; G O Oosterhof; J R Thornbury; J O Barentsz Journal: AJR Am J Roentgenol Date: 1996-04 Impact factor: 3.959
Authors: Andrew B Rosenkrantz; Christian Geppert; Robert Grimm; Tobias K Block; Christian Glielmi; Li Feng; Ricardo Otazo; Justin M Ream; Melanie Moccaldi Romolo; Samir S Taneja; Daniel K Sodickson; Hersh Chandarana Journal: J Magn Reson Imaging Date: 2014-05-16 Impact factor: 4.813
Authors: Giovanni Luca Gravina; Vincenzo Tombolini; Mario Di Staso; Pietro Franzese; Pierluigi Bonfili; Antonio Gennarelli; Leda Di Nicola; Carlo Masciocchi; Ernesto Di Cesare Journal: Eur Radiol Date: 2012-07-14 Impact factor: 5.315