Eugenio Martorana1, Giacomo Maria Pirola1, Michele Scialpi2, Salvatore Micali1, Andrea Iseppi1, Luca Reggiani Bonetti3, Shaniko Kaleci4, Pietro Torricelli5, Giampaolo Bianchi1. 1. Department of Urology, University of Modena and Reggio Emilia, Modena, Italy. 2. Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, Perugia, Italy. 3. Department of Diagnostic Medicine and Public Health -Section of Pathology, University of Modena and Reggio Emilia, Modena, Italy. 4. Department of Medical Statistic, University of Modena and Reggio Emilia, Modena, Italy. 5. Department of Diagnostic Imaging, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
OBJECTIVE: To demonstrate the association between magnetic resonance imaging (MRI) estimated lesion volume (LV), prostate cancer detection and tumour clinical significance, evaluating this variable alone and matched with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) score. PATIENTS AND METHODS: We retrospectively analysed 157 consecutive patients, with at least one prior negative systematic prostatic biopsy, who underwent transperineal prostate MRI/ultrasonography fusion-targeted biopsy between January 2014 and February 2016. Suspicious lesions were delineated using a 'region of interest' and the system calculated prostate volume and LV. Patients were divided in groups considering LV (≤0.5, 0.5-1, ≥1 mL) and PI-RADS score (1-5). We considered clinically significant prostate cancer as all cancers with a Gleason score of ≥3 + 4 as suggested by PI-RADS v2. A direct comparison between MRI estimated LV (MRI LV) and histological tumour volume (HTV) was done in 23 patients who underwent radical prostatectomy during the study period. Differences between MRI LV and HTV were assessed using the paired sample t-test. MRI LV and HTV concordance was verified using a Bland-Altman plot. The chi-squared test and logistic and ordinal regression models were used to evaluate difference in frequencies. RESULTS: The MRI LV and PI-RADS score were associated both with prostate cancer detection (both P < 0.001) and with significant prostate cancer detection (P < 0.001 and P = 0.008, respectively). When the two variables were matched, increasing LV increased the risk within each PI-RADS group. Prostate cancer detection was 1.4-times higher for LVs of 0.5-1 mL and 1.8-times higher for LVs of ≥1 mL; significant prostate cancer detection was 2.6-times for LVs of 0.5-1 mL and 4-times for LVs of ≥1 mL. There was a positive correlation between MRI LV and HTV (r = 0.9876, P < 0.001). Finally, Bland-Altman analysis showed that MRI LV was underestimated by 4.2% compared to HTV. Study limitations include its monocentric and retrospective design and the limited cohort. CONCLUSIONS: This study demonstrates that PI-RADS score and the MRI LV, independently and in combination, are associated with prostate cancer detection and with tumour clinical significance.
OBJECTIVE: To demonstrate the association between magnetic resonance imaging (MRI) estimated lesion volume (LV), prostate cancer detection and tumour clinical significance, evaluating this variable alone and matched with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) score. PATIENTS AND METHODS: We retrospectively analysed 157 consecutive patients, with at least one prior negative systematic prostatic biopsy, who underwent transperineal prostate MRI/ultrasonography fusion-targeted biopsy between January 2014 and February 2016. Suspicious lesions were delineated using a 'region of interest' and the system calculated prostate volume and LV. Patients were divided in groups considering LV (≤0.5, 0.5-1, ≥1 mL) and PI-RADS score (1-5). We considered clinically significant prostate cancer as all cancers with a Gleason score of ≥3 + 4 as suggested by PI-RADS v2. A direct comparison between MRI estimated LV (MRI LV) and histological tumour volume (HTV) was done in 23 patients who underwent radical prostatectomy during the study period. Differences between MRI LV and HTV were assessed using the paired sample t-test. MRI LV and HTV concordance was verified using a Bland-Altman plot. The chi-squared test and logistic and ordinal regression models were used to evaluate difference in frequencies. RESULTS: The MRI LV and PI-RADS score were associated both with prostate cancer detection (both P < 0.001) and with significant prostate cancer detection (P < 0.001 and P = 0.008, respectively). When the two variables were matched, increasing LV increased the risk within each PI-RADS group. Prostate cancer detection was 1.4-times higher for LVs of 0.5-1 mL and 1.8-times higher for LVs of ≥1 mL; significant prostate cancer detection was 2.6-times for LVs of 0.5-1 mL and 4-times for LVs of ≥1 mL. There was a positive correlation between MRI LV and HTV (r = 0.9876, P < 0.001). Finally, Bland-Altman analysis showed that MRI LV was underestimated by 4.2% compared to HTV. Study limitations include its monocentric and retrospective design and the limited cohort. CONCLUSIONS: This study demonstrates that PI-RADS score and the MRI LV, independently and in combination, are associated with prostate cancer detection and with tumour clinical significance.
Authors: Eugenio Martorana; Giacomo Maria Pirola; Maria Cristina Aisa; Pietro Scialpi; Aldo Di Blasi; Giovanni Saredi; Alfredo D'Andrea; Stefano Signore; Riccardo Grisanti; Michele Scialpi Journal: Turk J Urol Date: 2019-07-01
Authors: Niklas Westhoff; Henning Haumann; Maximilian Christian Kriegmair; Jost von Hardenberg; Johannes Budjan; Stefan Porubsky; Maurice Stephan Michel; Patrick Honeck; Manuel Ritter Journal: World J Urol Date: 2018-12-17 Impact factor: 4.226
Authors: Andrew McPartlin; Lucy Kershaw; Alan McWilliam; Marcus Ben Taylor; Clare Hodgson; Marcel van Herk; Ananya Choudhury Journal: Ther Adv Urol Date: 2018-10-11
Authors: Alex Z Wang; Luke P O’Conno; Nitin K Yerram; Lori Long; Johnathan Zeng; Sherif Mehralivand; Stephanie A Harmon; Amir H Lebastchi; Michael Ahdoot; Patrick T Gomella; Sandeep Gurram; Peter L Choyke; Maria J Merino; Joanna H Shih; Bradford J Wood; Baris Turkbey; Peter A Pinto Journal: J Urol Date: 2020-07-27 Impact factor: 7.450