Literature DB >> 24220253

Value of 3-T multiparametric magnetic resonance imaging and magnetic resonance-guided biopsy for early risk restratification in active surveillance of low-risk prostate cancer: a prospective multicenter cohort study.

Caroline M A Hoeks1, Diederik M Somford, Inge M van Oort, Henk Vergunst, Jorg R Oddens, Geert A Smits, Monique J Roobol, Meelan Bul, Thomas Hambrock, J Alfred Witjes, Jurgen J Fütterer, Christina A Hulsbergen-van de Kaa, Jelle O Barentsz.   

Abstract

OBJECTIVES: The objective of this study was to evaluate the role of 3-T multiparametric magnetic resonance imaging (MP-MRI) and magnetic resonance-guided biopsy (MRGB) in early risk restratification of patients on active surveillance at 3 and 12 months of follow-up.
MATERIALS AND METHODS: Within 4 hospitals participating in a large active surveillance trial, a side study was initiated. Pelvic magnetic resonance imaging, prostate MP-MRI, and MRGB were performed at 3 and 12 months (latter prostate MP-MRI and MRGB only) after prostate cancer diagnosis in 1 of the 4 participating hospitals. Cancer-suspicious regions (CSRs) were defined on prostate MP-MRI using Prostate Imaging Reporting And Data System (PI-RADS) scores.Risk restratification criteria for active surveillance discontinuance were (1) histopathologically proven magnetic resonance imaging suspicion of node/bone metastases and/or (2) a Gleason growth pattern (GGP) 4 and/or 5 and/or cancer multifocality (≥3 foci) in MRGB specimens of a CSR on MP-MRI.
RESULTS: From 2009 to 2012, a total of 64 of 82 patients were consecutively and prospectively included and underwent MP-MRI and a subsequent MRGB. At 3 and 12 months of follow-up, 14% (9/64) and 10% (3/30) of the patients were risk-restratified on the basis of MP-MRI and MRGB. An overall CSR PI-RADS score of 1 or 2 had a negative predictive value of 84% (38/45) for detection of any prostate cancer and 100% (45/45) for detection of a GGP 4 or 5 containing cancer upon MRGB, respectively. A CSR PI-RADS score of 4 or higher had a sensitivity of 92% (11/12) for detection of a GGP 4 or 5 containing cancer upon MRGB.
CONCLUSIONS: Application of MP-MRI and MRGB in active surveillance may contribute in early identification of patients with GGP 4 or 5 containing cancers at 3 months of follow-up. If, during further follow-up, a PI-RADS score of 1 or 2 continues to have a negative predictive value for GGP 4 or 5 containing cancers, a PI-RADS standardized reported MP-MRI may be a promising tool for the selection of prostate cancer patients suitable for active surveillance.

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Year:  2014        PMID: 24220253     DOI: 10.1097/RLI.0000000000000008

Source DB:  PubMed          Journal:  Invest Radiol        ISSN: 0020-9996            Impact factor:   6.016


  29 in total

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9.  Evaluation of the PI-RADS scoring system for mpMRI of the prostate: a whole-mount step-section analysis.

Authors:  Daniel Junker; Michael Quentin; Udo Nagele; Michael Edlinger; Jonathan Richenberg; Georg Schaefer; Michael Ladurner; Werner Jaschke; Wolfgang Horninger; Friedrich Aigner
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10.  Abnormal findings on multiparametric prostate magnetic resonance imaging predict subsequent biopsy upgrade in patients with low risk prostate cancer managed with active surveillance.

Authors:  Robert R Flavell; Antonio C Westphalen; Carmin Liang; Christopher C Sotto; Susan M Noworolski; Daniel B Vigneron; Zhen J Wang; John Kurhanewicz
Journal:  Abdom Imaging       Date:  2014-10
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