Biparametric 3T Magnetic Resonance Imaging for prostatic cancer detection in a biopsy-naïve patient population: a further improvement of PI-RADS v2?

Eur J Radiol. 2016 Dec;85(12):2269-2274. doi: 10.1016/j.ejrad.2016.10.009. Epub 2016 Oct 14.

Abstract

Objectives: To prospectively determine the diagnostic accuracy of a biparametric 3T magnetic resonance imaging protocol (BP-MRI) for prostatic cancer detection, compared to a multiparametric MRI protocol (MP-MRI), in a biopsy naïve patient population.

Methods: Eighty-two untreated patients (mean age 65±7.6years) with clinical suspicion of prostate cancer and/or altered prostate-specific antigen (PSA) levels underwent a MP-MRI, including T2-weighted imaging, diffusion-weighted imaging (with the correspondent apparent diffusion coefficient maps) and dynamic contrast enhanced sequence, followed by prostate biopsy. Two radiologists reviewed both the BP-MRI and the MP-MRI protocols to establish a radiological diagnosis. Receiver operating characteristics curves were obtained to determine the diagnostic performance of the two protocols.

Results: The mean PSA level was 8.8±8.1ng/ml. A total of 34 prostatic tumors were identified, with a Gleason score that ranged from 3+3 to 5+4. Of these 34 tumors, 29 were located within the peripheral zone and 5 in the transitional zone. BP-MRI and MP-MRI showed a similar performance in terms of overall diagnostic accuracy, with an area under the curve of 0.91 and 0.93, respectively (p=n.s.).

Conclusions: BP-MRI prostate protocol is feasible for prostatic cancer detection compared to a standard MP-MRI protocol, requiring a shorter acquisition and interpretation time, with comparable diagnostic accuracy to the conventional protocol, without the administration of gadolinium-based contrast agent.

Keywords: MRI; Medical oncology; PI-RADS; Prostate cancer; Urologic diseases.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging / methods
  • Diffusion Magnetic Resonance Imaging / statistics & numerical data
  • Feasibility Studies
  • Humans
  • Image Enhancement / methods
  • Image Processing, Computer-Assisted / methods
  • Image-Guided Biopsy / methods
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Prospective Studies
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / diagnostic imaging*
  • ROC Curve
  • Ultrasonography, Interventional / methods

Substances

  • Contrast Media
  • Prostate-Specific Antigen