Additional Value of Dynamic Contrast-enhanced Sequences in Multiparametric Prostate Magnetic Resonance Imaging: Data from the PROMIS Study

Bosaily, Ahmed El-Shater; Frangou, Elena; Ahmed, Hashim U.; Emberton, Mark; Punwani, Shonit; Kaplan, Richard; Brown, Louise; Freeman, Alex; Jameson, Charles; Hindley, Richard G.; Peppercorn, Delia; Thrower, Andrew; Winkler, Mathias; Barwick, Tara; Stewart, Victoria; Burns-Cox, Nick; Burn, Paul; Ghei, Maneesh; Kumaradevan, Jeevan; Prasad, Raj; Ash-Miles, Janice; Shergill, Iqbal; Agarwal, Sanjay; Rosario, Derek J.; Salim, Ferekh; Bott, Simon; Evans, Hywel; Henderson, Alastair; Ghosh, Sukanya; Dudderidge, Tim; Smart, J; Tung, Ken; Kirkham, Alex

doi:10.1016/j.eururo.2020.03.002

Cited by 36 publications

(14 citation statements)

References 30 publications

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“…The present study provided evidence that an abbreviated biparametric MRI protocol consisting in axial T2WI and high b-value DWI sequences only (<10 min scan time) could match the performance of full biparametric and multiparametric MRI protocols for the detection of csPCa when interpreted by experienced radiologists. Our findings support emerging evidence on the limited utility of DCE for PCa detection [ 27 , 28 ], and are in line with similar studies that investigated abbreviated bpMRI protocols [ 11 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionsupporting

confidence: 91%

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

et al. 2022

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(1) Background: There is currently limited evidence on the diagnostic accuracy of abbreviated biparametric MRI (a-bpMRI) protocols for prostate cancer (PCa) detection and screening. In the present study, we aim to investigate the performance of a-bpMRI among multiple readers and its potential application to an imaging-based screening setting. (2) Methods: A total of 151 men who underwent 3T multiparametric MRI (mpMRI) of the prostate and transperineal template prostate mapping biopsies were retrospectively selected. Corresponding bpMRI (multiplanar T2WI, DWI, ADC maps) and a-bpMRI (axial T2WI and b 2000 s/mm2 DWI only) dataset were derived from mpMRI. Three experienced radiologists scored a-bpMRI, standard biparametric MRI (bpMRI) and mpMRI in separate sessions. Diagnostic accuracy and interreader agreement of a-bpMRI was tested for different positivity thresholds and compared to bpMRI and mpMRI. Predictive values of a-bpMRI were computed for lower levels of PCa prevalence to simulate a screening setting. The primary definition of clinically significant PCa (csPCa) was Gleason ≥ 4 + 3, or cancer core length ≥ 6 mm. (3) Results: The median age was 62 years, the median PSA was 6.8 ng/mL, and the csPCa prevalence was 40%. Using a cut off of MRI score ≥ 3, the sensitivity and specificity of a-bpMRI were 92% and 48%, respectively. There was no significant difference in sensitivity compared to bpMRI and mpMRI. Interreader agreement of a-bpMRI was moderate (AC1 0.58). For a low prevalence of csPCa (e.g., <10%), higher cut offs (MRI score ≥ 4) yield a more favourable balance between the predictive values and positivity rate of MRI. (4) Conclusion: Abbreviated bpMRI protocols could match the diagnostic accuracy of bpMRI and mpMRI for the detection of csPCa. If a-bpMRI is used in low-prevalence settings, higher cut-offs for MRI positivity should be prioritised.

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Section: Discussionsupporting

confidence: 91%

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

et al. 2022

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“…The capability of DCE to adequately delimitate prostate nodular lesions, even of small dimensions, could be of particular importance also for the adequate measurement of the lesion volume, which helps improve the diagnostic yield of the targeted biopsy. To our knowledge, however, there are still no studies that quantify this aspect (68).…”

Section: Small Cancer Detectionmentioning

confidence: 99%

“…The validity of this study is mainly related to the application of the trans-perianal mapping biopsy performed independently of the MRI results, that allowed avoiding potential bias related to the use of biopsy to confirm MR findings. Moreover, even the poor comparability with other PIRADS-based studies, the use of a five-point Likert scale (as in the PROMIS study) allowed also detecting any potential advantages of DCE, unlike the PIRADS, which currently define DCE only as a dichotomous variable (68).…”

Section: Literature On Diagnostic Validitymentioning

confidence: 99%

Biparametric (bp) and multiparametric (mp) magnetic resonance imaging (MRI) approach to prostate cancer disease: a narrative review of current debate on dynamic contrast enhancement

et al. 2020

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Prostate cancer is the most common malignancy in male population. Over the last few years, magnetic resonance imaging (MRI) has proved to be a robust clinical tool for identification and staging of clinically significant prostate cancer. Though suggestions by the European Society of Urogenital Radiology to use complete multiparametric (mp) T2-weighted/diffusion weighted imaging (DWI)/dynamic contrast enhancement (DCE) acquisition for all prostate MRI examinations, the real advantage of functional DCE remains a matter of debate. Recent studies demonstrate that biparametric (bp) and mp approaches have similar accuracy, but controversial evidences remain, and the specific potential benefits of contrast medium administration are still poorly discussed in literature. The bp approach is in fact sufficient in most cases to adequately identify a negative test, or to accurately define the degree of aggressiveness of a lesion, especially if larger or with major characteristics of malignancy. This feature would give the DCE a secondary role, probably limited to a second evaluation of the lesion location, for detecting small cancer or in case of controversy. However, DCE has proved to increase the sensitivity of prostate MRI, though a less specificity.Therefore, an appropriate decision algorithm is needed to standardize the MRI approach. Aim of this review study was to provide a schematic description of bpMRI and mpMRI approaches in the study of prostatic anatomy, focusing on comparative validity and current DCE application. Additional theoretical considerations on prostate MRI are provided.

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“… 21 Biparametric MRI (bpMRI) has been considered as a potential alternative to mpMRI. 22 Although its diagnostic utility is still being appraised, there is a growing interest in this modality as it has been suggested that it could reduce costs and imaging times. 23 24 Further exploration of the role of MRI in predicting BCR after radical prostatectomy is necessary as its use in this way could enhance and improve existing models of prostate cancer prognosis, allowing for better clinical decision making and patient care.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes associated with prostate cancer conspicuity on biparametric and multiparametric MRI: a protocol for a systematic review and meta-analysis of biochemical recurrence following radical prostatectomy

et al. 2021

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IntroductionThere is an increasing body of evidence to suggest that visibility of prostate cancer on magnetic resonance (MRI) may be related to likelihood of adverse pathological outcomes. Biochemical recurrence (BCR) after radical prostatectomy remains a significant clinical challenge and a means of predicting likelihood of this prior to surgery could inform treatment choice. It appears that MRI could be a potential candidate strategy for BCR prediction, and as such, there is a need to review extant literature on the prognostic capability of MRI. Here, we describe a protocol for a systematic review and meta-analysis of the utility of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) in predicting BCR following radical prostatectomy for prostate cancer treatment.Methods and analysisPubMed, MEDLINE, Embase and Cochrane databases will be searched and screening will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. In order to meet the inclusion criteria, papers must be English-language articles involving patients who have had bpMRI or mpMRI for suspected prostate cancer and have undergone radical prostatectomy as definitive therapy. Patients must have had prostate-specific antigen monitoring before and after surgery. All relevant papers published from July 1977 to October 2020 will be eligible for inclusion. The Newcastle-Ottawa score will be used to determine the quality and bias of the studies. This protocol is written in-line with the PRISMA protocol 2015 checklist.Ethics and disseminationThere are no relevant ethical concerns. Dissemination of this protocol will be via peer-reviewed journals as well as national and international conferences.PROSPERO registration numberCRD42020206074.

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Additional Value of Dynamic Contrast-enhanced Sequences in Multiparametric Prostate Magnetic Resonance Imaging: Data from the PROMIS Study

Cited by 36 publications

References 30 publications

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

Diagnostic Accuracy of Abbreviated Bi-Parametric MRI (a-bpMRI) for Prostate Cancer Detection and Screening: A Multi-Reader Study

Biparametric (bp) and multiparametric (mp) magnetic resonance imaging (MRI) approach to prostate cancer disease: a narrative review of current debate on dynamic contrast enhancement

Clinical outcomes associated with prostate cancer conspicuity on biparametric and multiparametric MRI: a protocol for a systematic review and meta-analysis of biochemical recurrence following radical prostatectomy

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