OBJECTIVES: To evaluate the Prostate Imaging Reporting and Data System (PIRADS) in multiparametric magnetic resonance imaging (mpMRI) based on single cores and single-core histology. To calculate positive (PPV) and negative predictive values (NPV) of different modalities of mpMRI. PATIENTS AND METHODS: We performed MRI-targeted transrectal ultrasound-guided perineal prostate biopsies on 50 patients (mean age 66 years, mean PSA level of 9.9 ng/mL) with suspicion of prostate cancer. The biopsy trajectories of every core taken were documented in three dimensions (3D) in a 3D-prostate model. Every core was evaluated separately for prostate cancer and the performed biopsy trajectories were projected on mpMRI images. PIRADS scores of 1177 cores were then assessed by a histology 'blinded' uro-radiologist in T2-weighted (T2W), dynamic contrast-enhanced (DCE), diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS). RESULTS: The PIRADS score was significantly higher in cores positive for cancer than in negative cores. There was a significant correlation between the PIRADS score and histopathology for every modality. Receiver operating characteristic (ROC) analysis showed excellent specificity for T2W (90% peripheral zone/97% transition zone) and DWI (98%/97%) images regardless of the prostate region observed. These numbers decreased for DCE (80%/93%) and MRS (76%/83%). All modalities had NPVs of 99%, if a PIRADS score threshold of 2 (for T2W, DCE, and MRS) or 3 (for DWI) was used. However, PPVs were low. CONCLUSIONS: Our results show that PIRADS scoring is feasible for clinical routine and allows standardised reporting. PIRADS can be used as a decision-support system for targeting of suspicious lesions. mpMRI has a high NPV for prostate cancer and, thus, might be a valuable tool in the initial diagnostic evaluation.
OBJECTIVES: To evaluate the Prostate Imaging Reporting and Data System (PIRADS) in multiparametric magnetic resonance imaging (mpMRI) based on single cores and single-core histology. To calculate positive (PPV) and negative predictive values (NPV) of different modalities of mpMRI. PATIENTS AND METHODS: We performed MRI-targeted transrectal ultrasound-guided perineal prostate biopsies on 50 patients (mean age 66 years, mean PSA level of 9.9 ng/mL) with suspicion of prostate cancer. The biopsy trajectories of every core taken were documented in three dimensions (3D) in a 3D-prostate model. Every core was evaluated separately for prostate cancer and the performed biopsy trajectories were projected on mpMRI images. PIRADS scores of 1177 cores were then assessed by a histology 'blinded' uro-radiologist in T2-weighted (T2W), dynamic contrast-enhanced (DCE), diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS). RESULTS: The PIRADS score was significantly higher in cores positive for cancer than in negative cores. There was a significant correlation between the PIRADS score and histopathology for every modality. Receiver operating characteristic (ROC) analysis showed excellent specificity for T2W (90% peripheral zone/97% transition zone) and DWI (98%/97%) images regardless of the prostate region observed. These numbers decreased for DCE (80%/93%) and MRS (76%/83%). All modalities had NPVs of 99%, if a PIRADS score threshold of 2 (for T2W, DCE, and MRS) or 3 (for DWI) was used. However, PPVs were low. CONCLUSIONS: Our results show that PIRADS scoring is feasible for clinical routine and allows standardised reporting. PIRADS can be used as a decision-support system for targeting of suspicious lesions. mpMRI has a high NPV for prostate cancer and, thus, might be a valuable tool in the initial diagnostic evaluation.
Authors: Anna Grenabo Bergdahl; Ulrica Wilderäng; Gunnar Aus; Sigrid Carlsson; Jan-Erik Damber; Maria Frånlund; Kjell Geterud; Ali Khatami; Andreas Socratous; Johan Stranne; Mikael Hellström; Jonas Hugosson Journal: Eur Urol Date: 2015-12-24 Impact factor: 20.096
Authors: Daniel I Glazer; William W Mayo-Smith; Nisha I Sainani; Cheryl A Sadow; Mark G Vangel; Clare M Tempany; Ruth M Dunne Journal: AJR Am J Roentgenol Date: 2017-06-28 Impact factor: 3.959
Authors: Xiaosong Meng; Andrew B Rosenkrantz; Neil Mendhiratta; Michael Fenstermaker; Richard Huang; James S Wysock; Marc A Bjurlin; Susan Marshall; Fang-Ming Deng; Ming Zhou; Jonathan Melamed; William C Huang; Herbert Lepor; Samir S Taneja Journal: Eur Urol Date: 2015-06-22 Impact factor: 20.096
Authors: Daniel Junker; Michael Quentin; Udo Nagele; Michael Edlinger; Jonathan Richenberg; Georg Schaefer; Michael Ladurner; Werner Jaschke; Wolfgang Horninger; Friedrich Aigner Journal: World J Urol Date: 2014-08-01 Impact factor: 4.226
Authors: Neil Mendhiratta; Xiaosong Meng; Andrew B Rosenkrantz; James S Wysock; Michael Fenstermaker; Richard Huang; Fang-Ming Deng; Jonathan Melamed; Ming Zhou; William C Huang; Herbert Lepor; Samir S Taneja Journal: Urology Date: 2015-08-31 Impact factor: 2.649
Authors: S Kaufmann; J Bedke; S Gatidis; J Hennenlotter; U Kramer; M Notohamiprodjo; K Nikolaou; A Stenzl; S Kruck Journal: World J Urol Date: 2015-08-13 Impact factor: 4.226