Multiparametric pelvic MRI accuracy in diagnosing clinically significant prostate cancer in the reevaluation of biopsy microfocal tumor

Abstract

Aim: To evaluate the accuracy of multi-parametric pelvic magnetic resonance imaging (mpMRI) in diagnosing prostate cancer (PCa) in men with initial biopsy microfocal cancer.

Patients and methods: From January 2012 to July 2014, 40 patients before undergoing repeat transperineal saturation prostate biopsy (SPBx; median, 28 cores) for the presence of a microfocal PCa were submitted to 3.0-Tesla mpMRI.

Results: A T1c clinical stage PCa was found in 23 (57.5%) patients submitted to SPBx; mpMRI was positive in 16/40 (40%) cases and in 11 of them a clinically significant PCa was found. On the contrary, the 12 men with negative mpMRI had a quantitative histology suitable for clinically insignificant cancer. Diagnostic accuracy of mpMRI in diagnosing significant PCa was equal to 100%.

Conclusion: Multi-parametric pMRI should be suggested in the re-evaluation of microfocal cancer as a selection approach of patients at risk for clinically significant PCa.

Keywords: Prostate cancer; microfocal prostate cancer; multi-parametric MRI.