Shobhit Mathur1, Martin E O'Malley2, Sangeet Ghai3, Kartik Jhaveri2, Boraiah Sreeharsha2, Myles Margolis4, Lehang Zhong5, Hassan Maan3, Ants Toi4. 1. Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave., Toronto, ON, M5G 2N2, Canada. shobhit.mathur@uhn.ca. 2. Joint Department of Medical Imaging, Princess Margaret Hospital, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada. 3. Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave., Toronto, ON, M5G 2N2, Canada. 4. Joint Department of Medical Imaging, Mount Sinai Hospital, University of Toronto, 600 University Ave., Toronto, ON, M5G 1X5, Canada. 5. Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
Abstract
OBJECTIVE: To correlate the findings on 3T multiparametric prostate MRI using PIRADS version 2 with prostate biopsy results as the standard of reference. MATERIALS AND METHODS: 134 consecutive treatment naive patients (mean age 64 years, range 41-82 years) underwent MRI-directed prostate biopsy. MRI-TRUS fusion biopsy was used for 77 (77/134 = 57.5%) patients, cognitive fusion for 51 (51/134 = 38.0%) patients, and 6 patients (6/134 = 4.5%) without a target nodule had systematic biopsy only. Out of the 1676 biopsy sites, 237 (237/1676 = 14.1%) were positive on MRI for a PIRADS 3, 4, or 5 nodule. Fifty-eight (58/134, 43.3%) patients had clinically significant prostate cancer (csPCa). The findings on MRI using PIRADS version 2 were correlated with the biopsy results. RESULTS: The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of PIRADS ≥ 3 for csPCa were 89%, 76.5%, 89.7%, 31.7%, and 98.4%, respectively. The detection rates of csPCa for PIRADS 3, 4, and 5 nodules were 6.1% (4/66), 33.3% (42/126), and 64.4% (29/45), respectively. MRI did not identify a nodule in 23/1676 (1.4%) biopsy sites that contained csPCa. The MRI reader, biopsy operator, method of fusion biopsy, and zonal location of prostate nodule did not significantly affect the odds of having a biopsy result positive for csPCa. CONCLUSION: PIRADS ≥ 3 had high specificity and high negative predictive value for csPCa using biopsy results as the standard of reference. The presence of csPCa from a biopsy site was highly unlikely in the absence of a corresponding PIRADS ≥ 3 nodule.
OBJECTIVE: To correlate the findings on 3T multiparametric prostate MRI using PIRADS version 2 with prostate biopsy results as the standard of reference. MATERIALS AND METHODS: 134 consecutive treatment naive patients (mean age 64 years, range 41-82 years) underwent MRI-directed prostate biopsy. MRI-TRUS fusion biopsy was used for 77 (77/134 = 57.5%) patients, cognitive fusion for 51 (51/134 = 38.0%) patients, and 6 patients (6/134 = 4.5%) without a target nodule had systematic biopsy only. Out of the 1676 biopsy sites, 237 (237/1676 = 14.1%) were positive on MRI for a PIRADS 3, 4, or 5 nodule. Fifty-eight (58/134, 43.3%) patients had clinically significant prostate cancer (csPCa). The findings on MRI using PIRADS version 2 were correlated with the biopsy results. RESULTS: The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of PIRADS ≥ 3 for csPCa were 89%, 76.5%, 89.7%, 31.7%, and 98.4%, respectively. The detection rates of csPCa for PIRADS 3, 4, and 5 nodules were 6.1% (4/66), 33.3% (42/126), and 64.4% (29/45), respectively. MRI did not identify a nodule in 23/1676 (1.4%) biopsy sites that contained csPCa. The MRI reader, biopsy operator, method of fusion biopsy, and zonal location of prostate nodule did not significantly affect the odds of having a biopsy result positive for csPCa. CONCLUSION: PIRADS ≥ 3 had high specificity and high negative predictive value for csPCa using biopsy results as the standard of reference. The presence of csPCa from a biopsy site was highly unlikely in the absence of a corresponding PIRADS ≥ 3 nodule.
Entities:
Keywords:
PI-RADS; Prostate MRI; Prostate biopsy; Prostate cancer