Katja Bogner1, Karl Engelhard2, Wolfgang Wuest2, Sajad Hamel2. 1. Institute of Radiology, Martha-Maria Hospital, Stadenstrasse 58, 90491, Nuremberg, Germany. Katja.Bogner@Martha-Maria.de. 2. Institute of Radiology, Martha-Maria Hospital, Stadenstrasse 58, 90491, Nuremberg, Germany.
Abstract
PURPOSE: To evaluate the validity of PI-RADS categories 1 and 2 version 2.1 (V2.1) as predictors of the absence of carcinoma and to reevaluate lesions that were analysed as suspicious prior to PI-RADS or according to PI-RADS versions 1 and 2 and classified as PI-RADS 1 or 2 in V2.1. METHODS: Retrospective evaluation of 1170 multiparametric MRIs performed at one academic teaching hospital (2012-2019). Study cohort comprised 188 men that achieved PI-RADS scores 1 or 2 (V2.1) and underwent systematic and targeted biopsy, split into one group with suspect findings in the original reports that were created prior to PI-RADS or with version 1 and 2, and another group with unremarkable reports. Differences in presence of prostate cancer and PSA density were assessed by Chi-square and Fisher's exact test, and the negative predictive value (NPV) for both groups was conducted. RESULTS: The NPV for clinically significant carcinoma (csCa) was 89.1% for 55 men with suspect findings in the original report and 93.2% for 133 men with negative MRI. There was no difference between the groups regarding the detection of csCa (p = 0.103). PSA density was significantly higher in the group with suspect original reports (p = 0.015). CONCLUSION: A PI-RADS score 1 or 2 appears less likely to miss existing prostate cancer, although a small amount of csCa can be overlooked. In case of clinical suspicion or elevated PSA density and PI-RADS score 1 or 2, an individual decision has to be taken if biopsy is necessary or if monitoring is sufficient.
PURPOSE: To evaluate the validity of PI-RADS categories 1 and 2 version 2.1 (V2.1) as predictors of the absence of carcinoma and to reevaluate lesions that were analysed as suspicious prior to PI-RADS or according to PI-RADS versions 1 and 2 and classified as PI-RADS 1 or 2 in V2.1. METHODS: Retrospective evaluation of 1170 multiparametric MRIs performed at one academic teaching hospital (2012-2019). Study cohort comprised 188 men that achieved PI-RADS scores 1 or 2 (V2.1) and underwent systematic and targeted biopsy, split into one group with suspect findings in the original reports that were created prior to PI-RADS or with version 1 and 2, and another group with unremarkable reports. Differences in presence of prostate cancer and PSA density were assessed by Chi-square and Fisher's exact test, and the negative predictive value (NPV) for both groups was conducted. RESULTS: The NPV for clinically significant carcinoma (csCa) was 89.1% for 55 men with suspect findings in the original report and 93.2% for 133 men with negative MRI. There was no difference between the groups regarding the detection of csCa (p = 0.103). PSA density was significantly higher in the group with suspect original reports (p = 0.015). CONCLUSION: A PI-RADS score 1 or 2 appears less likely to miss existing prostate cancer, although a small amount of csCa can be overlooked. In case of clinical suspicion or elevated PSA density and PI-RADS score 1 or 2, an individual decision has to be taken if biopsy is necessary or if monitoring is sufficient.
Authors: Jeffrey C Weinreb; Jelle O Barentsz; Peter L Choyke; Francois Cornud; Masoom A Haider; Katarzyna J Macura; Daniel Margolis; Mitchell D Schnall; Faina Shtern; Clare M Tempany; Harriet C Thoeny; Sadna Verma Journal: Eur Urol Date: 2015-10-01 Impact factor: 20.096
Authors: Nicolas Mottet; Joaquim Bellmunt; Michel Bolla; Erik Briers; Marcus G Cumberbatch; Maria De Santis; Nicola Fossati; Tobias Gross; Ann M Henry; Steven Joniau; Thomas B Lam; Malcolm D Mason; Vsevolod B Matveev; Paul C Moldovan; Roderick C N van den Bergh; Thomas Van den Broeck; Henk G van der Poel; Theo H van der Kwast; Olivier Rouvière; Ivo G Schoots; Thomas Wiegel; Philip Cornford Journal: Eur Urol Date: 2016-08-25 Impact factor: 20.096
Authors: A V D'Amico; R Whittington; S B Malkowicz; D Schultz; K Blank; G A Broderick; J E Tomaszewski; A A Renshaw; I Kaplan; C J Beard; A Wein Journal: JAMA Date: 1998-09-16 Impact factor: 56.272
Authors: Baris Turkbey; Andrew B Rosenkrantz; Masoom A Haider; Anwar R Padhani; Geert Villeirs; Katarzyna J Macura; Clare M Tempany; Peter L Choyke; Francois Cornud; Daniel J Margolis; Harriet C Thoeny; Sadhna Verma; Jelle Barentsz; Jeffrey C Weinreb Journal: Eur Urol Date: 2019-03-18 Impact factor: 20.096
Authors: Antonio C Westphalen; Farhad Fazel; Hao Nguyen; Miguel Cabarrus; Katryana Hanley-Knutson; Katsuto Shinohara; Peter R Carroll Journal: Int Braz J Urol Date: 2019 Jul-Aug Impact factor: 1.541