598Negative prostatic biopsies and high risk patients. Is the combination of endorectal MRI and magnetic resonance spectroscopy imaging (MRSI) a useful tool? A preliminary study

Amsellem-Ouazana, Delphine; Younès, P.; Conquynquy, S.; Peyromaure, Michaël; Saighi, D.; Flam, T.; Debré, B; Zerbib, Marc

doi:10.1016/s1569-9056(05)80602-5

Cited by 42 publications

(84 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, strict criteria were used when defining abnormal areas at MR. We decided not to introduce an intermediate class for inconclusive or equivocal findings (20). In particular for MRSI we defined the choline + creatine/citrate ratio threshold for cancer suspicious at 0.80, as previously reported in the literature by some experience (10,11,20). The positive findings of our study showed the potential of these qualitative criteria.…”

Section: Discussionmentioning

confidence: 77%

“…In their study (10), however, only 57.1% of tumors correlated with MRSI in their localization. Amsellem-Ouazana et al (11), in a population of 42 cases with negative prostate biopsies and a PSA >4 ng/mL, reported that the sensitivity, specificity, PPV, NPV, and accuracy of MRI/MRSI for the detection of prostate adenocarcinoma was 73.3%, 96.3%, 91.6%, 86.6%, and 88%, respectively. In a population of only 20 cases with similar characteristics, Wetter et al (22) reported 100% sensitivity and 69% specificity of MRSI for tumor detection.…”

Section: Discussionmentioning

confidence: 99%

“…Men with persistently elevated serum PSA levels after a negative first random TRUS-guided prostate biopsy represent a great diagnostic challenge for urologists (10). The fact that additional rounds of conventional random biopsies do not improve the cancer detection rate in this group of patients shows the high false-negative rates of the current random biopsy technique (10)(11)(12)(13). On the basis of these outcomes there is a need for a more sensitive and accurate imaging modality to direct biopsy and to detect prostate cancer.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Value of Magnetic Resonance Spectroscopy Imaging and Dynamic Contrast-Enhanced Imaging for Detecting Prostate Cancer Foci in Men With Prior Negative Biopsy

Sciarra

Panebianco

Ciccariello

et al. 2010

Clinical Cancer Research

144

View full text Add to dashboard Cite

Purpose: This study aimed to prospectively analyze the role of magnetic resonance spectroscopy imaging (MRSI) and dynamic-contrast enhancement magnetic resonance (DCEMR) in the detection of prostate tumor foci in patients with persistently elevated prostate-specific antigen levels (in the range of ≥4 ng/mL to <10 ng/mL) and prior negative random trans-rectal ultrasound (TRUS)-guided biopsy.Experimental Design: This was a prospective randomized single-center study. One hundred and eighty eligible cases were included in the study. Patients in group A were submitted to a second random prostate biopsy, whereas patients in group B were submitted to a 1 H-MRSI-DCEMR examination and samples targeted on suspicious areas were associated to the random biopsy.Results: At the second biopsy, a prostate adenocarcinoma histologic diagnosis was found in 22 of 90 cases (24.4%) in group A and in 41 of 90 cases (45.5%) in group B (P = 0.01). On a patient-by-patient basis, MRSI had 92.3% sensitivity, 88.2% specificity, 85.7% positive predictive value (PPV), 93.7% negative predictive value (NPV), and 90% accuracy; DCEMR had 84.6 % sensitivity, 82.3% specificity, 78.5% PPV, 87.5% NPV, and 83.3% accuracy; and the association MRSI plus DCEMR had 92.6% sensitivity, 88.8% specificity, 88.7% PPV, 92.7% NPV, and 90.7% accuracy, for predicting prostate cancer detection.Conclusions: The combination of MRSI and DCEMR showed the potential to guide biopsy to cancer foci in patients with previously negative TRUS biopsy. To avoid a potential bias, represented from having taken more samples in group B (mean of cores, 12.17) than in group A (10 cores), in the future a MRSI/ DCEMR directed biopsy could be prospectively compared with a saturation biopsy procedure. Clin Cancer Res; 16(6); 1875-83. ©2010 AACR.At present, suspicion of prostate adenocarcinoma is mainly based on three tests: digital rectal examination, prostate-specific antigen (PSA), and trans-rectal ultrasound (TRUS), and is confirmed by TRUS-guided biopsies. The latter is recognized by urologists as the first choice in the diagnosis of prostate pathologies (1). All three modern imaging modalities, namely, computer tomography, ultrasonography, and magnetic resonance (MR), have been considered to have limitations in the diagnosis of prostate adenocarcinoma. Recently some studies (2-5) revealed the high diagnostic accuracy of combined proton 1H-magnetic resonance spectroscopic imaging (1H-MRSI) and dynamic contrast-enhanced imaging magnetic resonance (DCEMR) in the management of prostate cancer. The advantage of MRSI is that the spectroscopic analysis provides metabolic information regarding prostatic tissue by displaying the relative concentrations of chemical compounds within contiguous small volumes of interest (voxels). In the prostate the substances analyzed by MRSI are citrate, creatine, and choline. For practical purposes, prostate adenocarcinoma can be distinguished from healthy peripheral zone tissue on the basis of the (choline + creatine)/citrate ratio (5-7). Normal per...

show abstract

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Value of Magnetic Resonance Spectroscopy Imaging and Dynamic Contrast-Enhanced Imaging for Detecting Prostate Cancer Foci in Men With Prior Negative Biopsy

Sciarra

Panebianco

Ciccariello

et al. 2010

Clinical Cancer Research

144

View full text Add to dashboard Cite

show abstract

“…In a study of 24 patients, the sensitivity, specificity, positive and negative predictive values, and the accuracy of MRSI for prostate cancer detection were 70.6%, 66.7%, 57.1% and 58.3%, 83.3% [103] . In a study of 42 patients the sensitivity, specificity, positive and negative predictive values, and the accuracy of combined MRI/MRSI for prostate cancer detection were 73.3%, 96.3%, 91.6%, 86.6% and 88%, respectively [104] .…”

Section: To Guide Target Biopsy For Clinically Suspected Cancer In Pamentioning

confidence: 97%

Incremental value of magnetic resonance imaging in the advanced management of prostate cancer

Wang¹

2009

WJR

View full text Add to dashboard Cite

Prostate cancer is a major public health burden throughout the world. The high incidence of prostate cancer, combined with earlier detection and downstaging at the time of diagnosis, and the slow natural progression and biological heterogeneity of the disease, has made its management a complex and controversial issue. There is growing demand for patient-specific therapies that can minimize treatment morbidity while maximizing treatment benefits. There are a number of clinical parameters and clinical nomograms to help with the choice of treatment. Magnetic resonance imaging (MRI) is a technique which makes safer, more individualized therapies possible due to high spatial resolution, superior contrast resolution, multiplanar capability, and a large field of view. Other MRI techniques such as MR spectroscopic imaging, dynamic contrast-enhanced MRI or perfusion MRI, and diffusion-weighted imaging complement MRI by reflecting tissue biochemistry, Brownian motion of water molecules, and capillary wall permeability, respectively. This editorial review highlights the incremental value of MRI in the advanced management of prostate cancer to non-invasively improve cancer staging, biologic potential, treatment planning, therapy response, local recurrence, and to guide target biopsy for clinical suspected cancer with previous negative biopsy. Finally, some future prospects for MRI in prostate cancer management are given.

show abstract

“…Although the tumor detection rate of T2 weighted images is limited, especially in the central and transitional zone and results of multiparametric MRI studies are promising but heterogeneous (10)(11)(12)(13)(14)(15), MRI is widely accepted as the method of choice for the assessment of tumors at the organ margins (16). Positron emission tomography (PET) with radioactivelabeled choline has shown high sensitivity with respect to prostate cancer detection (17) but with the detriment of lower specificity due to unspecific uptake in benign and inflammatory intraprostatic lesions (18).…”

Section: Introductionmentioning

confidence: 99%

Combined PET/MRI Improves Diagnostic Accuracy in Patients with Prostate Cancer: A Prospective Diagnostic Trial

Hartenbach

Bechtloff

et al. 2014

Clinical Cancer Research

View full text Add to dashboard Cite

Purpose: The pretherapeutic assessment of prostate cancer is challenging and still holds the risk of overor undertreatment. This prospective trial investigates positron emission tomography (PET) with [ 18 F]fluoroethylcholine (FEC) combined with endorectal magnetic resonance imaging (MRI) for the assessment of primary prostate cancer.Experimental design: Patients with prostate cancer based on needle biopsy findings, scheduled for radical prostatectomy, were assessed by FEC-PET and MRI in identical positioning. After prostatectomy, imaging results were compared with histologic whole-mount sections, and the PET/MRI lesion-based semiquantitative FEC uptake was compared with biopsy Gleason scores and postoperative histology.Results: PET/MRI showed a patient-based sensitivity of 95% (36/38; 95% confidence interval (CI), 82%-99%). The analysis of 128 prostate lesions demonstrated a sensitivity/specificity/positive predictive value/ negative predictive value/accuracy of 67%/35%/59%/44%/54% (P ¼ 0.8295) for MRI and 85%/45%/68%/ 69%/68% (P ¼ 0.0021) for PET, which increased to 84%/80%/85%/78%/82% (P < 0.0001) by combined FEC-PET/MRI in lesions >5 mm (n ¼ 98). For lesions in patients with Gleason >6 tumors (n ¼ 43), MRI and PET achieved 73%/31%/71%/33%/60% (P ¼ 1.0000) and 90%/62%/84%/73%/81% (P ¼ 0.0010), which were improved to 87%/92%/96%/75%/88% (P < 0.0001) by combined PET/MRI. Applying semiquantitative PET analysis, carcinomas with Gleason scores >6 were distinguished from those with Gleason 6 with a specificity of 90% and a positive predictive value of 83% (P ¼ 0.0011; needle biopsy 71%/60%, P ¼ 0.1071).Conclusions: In a prospective diagnostic trial setting, combined FEC-PET/MRI achieved very high sensitivity in the detection of the dominant malignant lesion of the prostate, and markedly improved upon PET or MRI alone. Noninvasive Gleason score assessment was more precise than needle biopsy in this patient cohort. Hence, FEC-PET/MRI merits further investigation in trials of randomized, multiarm design.

show abstract

598Negative prostatic biopsies and high risk patients. Is the combination of endorectal MRI and magnetic resonance spectroscopy imaging (MRSI) a useful tool? A preliminary study

Cited by 42 publications

References 0 publications

Value of Magnetic Resonance Spectroscopy Imaging and Dynamic Contrast-Enhanced Imaging for Detecting Prostate Cancer Foci in Men With Prior Negative Biopsy

Value of Magnetic Resonance Spectroscopy Imaging and Dynamic Contrast-Enhanced Imaging for Detecting Prostate Cancer Foci in Men With Prior Negative Biopsy

Incremental value of magnetic resonance imaging in the advanced management of prostate cancer

Combined PET/MRI Improves Diagnostic Accuracy in Patients with Prostate Cancer: A Prospective Diagnostic Trial

Contact Info

Product

Resources

About