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

Stanzione, Arnaldo; Imbriaco, Massimo; Cocozza, Sirio; Fusco, Ferdinando; Rusconi, Giovanni; Nappi, Carmela; Mirone, Vincenzo; Mangiapia, Francesco; Brunetti, Arturo; Ragozzino, Alfonso; Longo, Nicola

doi:10.1016/j.ejrad.2016.10.009

Cited by 85 publications

(65 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some authors biopsize all PI-RADS score 3 lesions [44] leading to increased number of unnecessary biopsies, on the other hand, others have demonstrated that PI-RADS score 3 lesions are associated with low likelihood of clinically sPCa, concluding that these lesions should not be sampled but monitored only. [45] Several studies [25,29] have demonstrated the adequacy of MRI lesion volume estimation compared to histopathological tumor volume.…”

Section: Biparametric Mri Volume Calculation For the Management Of Scmentioning

confidence: 99%

“…[23,41] Recently, it has been demonstrated that the sensitivity of bpMRI at 3T without endorectal coil in the detection PCa is similar to that of mpMRI. [20,24,27,28,[42][43][44] The diagnostic value of bpMRI in men with or without prior biopsy and combined with PSA has been validated, resulting in an improved accuracy for detecting clinically significant PCa (sPCa) and representing an effective technique to direct biopsy needles under TRUS guidance, after MRI-ultrasonography fusion. [20,23,28] For diagnosis of clinically sPCa in patients with elevated PSA before biopsy, DCE was found to be an unnecessary imaging technique in the majority of patients evaluated by PI-RADS v2.…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

“…[24] The sensitivity rates of bpMRI and mpMRI at 3T without ERC in the detection of PCa are 61.8-97.6%, and 72.9-97.6%, respectively ( Table 2). [20,24,27,28,[42][43][44] Biparametric MRI: lesion detection and localization According to the criteria and lexicon of the PI-RADS v2 guidelines [18] , the bpMRI images' analysis is based on the recognition of lesion patterns on T2WI and DWI and corresponding ADC maps. Because in our experience DWI represents the predominant sequence to detect lesions both in PZ and TZ with confirmed image quality, for routine clinical work we recommend starting viewing DWI with high b-values (and the same sequence inverted) on ADC maps and subsequently at T2WI.…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

See 2 more Smart Citations

Biparametric MRI of the prostate

Scialpi

D’Andrea

Martorana

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

Biparametric Magnetic Resonance Imaging (bpMRI) of the prostate combining both morphologic T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) is emerging as an alternative to multiparametric MRI (mpMRI) to detect, to localize and to guide prostatic targeted biopsy in patients with suspicious prostate cancer (PCa). BpMRI overcomes some limitations of mpMRI such as the costs, the time required to perform the study, the use of gadolinium-based contrast agents and the lack of a guidance for management of score 3 lesions equivocal for significant PCa. In our experience the optimal and similar clinical results of the bpMRI in comparison to mpMRI are essentially related to the DWI that we consider the dominant sequence for detection suspicious PCa both in transition and in peripheral zone. In clinical practice, the adoption of bpMRI standardized scoring system, indicating the likelihood to diagnose a clinically significant PCa and establishing the management of each suspicious category (from 1 to 4), could represent the rationale to simplify and to improve the current interpretation of mpMRI based on Prostate Imaging and Reporting Archiving Data System version 2 (PI-RADS v2). In this review article we report and describe the current knowledge about bpMRI in the detection of suspicious PCa and a simplified PI-RADS based on bpMRI for management of each suspicious PCa categories to facilitate the communication between radiologists and urologists.

show abstract

Section: Biparametric Mri Volume Calculation For the Management Of Scmentioning

confidence: 99%

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Biparametric MRI of the prostate

Scialpi

D’Andrea

Martorana

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…An initial 3502 studies underwent title and abstract screening, of which 127 studies were retrieved for full‐text review. In all, 31 studies reporting on 9480 patients (4296 with prostate cancer) met the inclusion criteria for meta‐analysis; 25 studies reported on mpMRI DTA (7000 patients, 2954 with prostate cancer), 12 studies reported on bpMRI DTA (2716 patients, 1477 with prostate cancer), and six studies directly compared mpMRI and bpMRI (2047 patients, 1063 with prostate cancer). Table provides a summary of the included studies [22,34––63], while Table provides a risk of bias summary of the included studies [22,34––63].…”

Section: Resultsmentioning

confidence: 99%

“…Table provides a summary of the included studies [22,34––63], while Table provides a risk of bias summary of the included studies [22,34––63]. Seven studies were at high risk of bias , four were at low risk of bias , and the remaining 18 studies had an unclear risk of bias due to at least one of the four domains .…”

Section: Resultsmentioning

confidence: 99%

Biparametric vs multiparametric prostate magnetic resonance imaging for the detection of prostate cancer in treatment‐naïve patients: a diagnostic test accuracy systematic review and meta‐analysis

Alabousi¹,

Salameh

Gusenbauer

et al. 2019

BJU International

View full text Add to dashboard Cite

Objective To perform a diagnostic test accuracy (DTA) systematic review and meta‐analysis comparing multiparametric (diffusion‐weighted imaging [DWI], T2‐weighted imaging [T2WI], and dynamic contrast‐enhanced [DCE] imaging) magnetic resonance imaging (mpMRI) and biparametric (DWI and T2WI) MRI (bpMRI) in detecting prostate cancer in treatment‐naïve patients. Methods The Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica dataBASE (EMBASE) were searched to identify relevant studies published after 1 January 2012. Articles underwent title, abstract, and full‐text screening. Inclusion criteria consisted of patients with suspected prostate cancer, bpMRI and/or mpMRI as the index test(s), histopathology as the reference standard, and a DTA outcome measure. Methodological and DTA data were extracted. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)‐2 tool. DTA metrics were pooled using bivariate random‐effects meta‐analysis. Subgroup analysis was conducted to assess for heterogeneity. Results From an initial 3502 studies, 31 studies reporting on 9480 patients (4296 with prostate cancer) met the inclusion criteria for the meta‐analysis; 25 studies reported on mpMRI (7000 patients, 2954 with prostate cancer) and 12 studies reported on bpMRI DTA (2716 patients, 1477 with prostate cancer). Pooled summary statistics demonstrated no significant difference for sensitivity (mpMRI: 86%, 95% confidence interval [CI] 81–90; bpMRI: 90%, 95% CI 83–94) or specificity (mpMRI: 73%, 95% CI 64–81; bpMRI: 70%, 95% CI 42–83). The summary receiver operating characteristic curves were comparable for mpMRI (0.87) and bpMRI (0.90). Conclusions No significant difference in DTA was found between mpMRI and bpMRI in diagnosing prostate cancer in treatment‐naïve patients. Study heterogeneity warrants cautious interpretation of the results. With replication of our findings in dedicated validation studies, bpMRI may serve as a faster, cheaper, gadolinium‐free alternative to mpMRI.

show abstract

Comparison of Multiparametric and Fast MRI Protocols in Detecting Clinically Significant Prostate Cancer and a Detailed Cost Analysis

Alver

Yağcı

Utebey

et al. 2022

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background Due to the long acquisition time and high cost of multiparametric magnetic resonance imaging (mpMRI), biparametric and, more recently, fast prostate magnetic resonance imaging (fpMRI) protocols have been described. However, there is insufficient data about the diagnostic performance and cost of fpMRI. Purpose To compare the diagnostic performances and cost analysis of fpMRI and mpMRI in clinically significant prostate cancer (csPCA). Study Type Retrospective. Population A total of 103 patients (63 had csPCA) with a mean age of 66.83 (± 7.22) years were included. Field Strength/Sequence A 1.5‐T; T1‐ and T2‐weighted turbo spin‐echo imaging (T1WI and T2WI), echo‐planar diffusion‐weighted images, and dynamic contrast‐enhanced T1W imaging. Assessment Three readers independently evaluated the fpMRI and mpMRI images in different sessions blinded to all patient information. Diagnostic performances of fpMRI and mpMRI were evaluated. Kappa coefficient (κ) was used to determine the interreader and intrareader agreement. A detailed cost analysis was performed for each protocol. Statistical Tests Receiver operating characteristics analysis, area under the curve (AUC), and κ test were used. Diagnostic performance parameters were also calculated. Results Of the 63 malignant index lesions (csPCA), 53/63 of those (84.1%) originated from the peripheral zone and 10/63 lesions (15.9%) originated from the transition zone. The AUC values for fpMRI were 0.878 for reader 1, 0.937 for reader 2, and 0.855 for reader 3. For mpMRI, the AUC values were 0.893 for reader 1, 0.94 for reader 2, and 0.862 for reader 3. Inter and intrareader agreements were moderate to substantial (κ range, 0.5–0.79). The total cost per examination was calculated as €12.39 and €30.10 for fpMRI and mpMRI, respectively. Data Conclusions Fast MRI protocol has similar diagnostic performance with mpMRI in detecting csPCA, and fpMRI can be considered an alternative protocol that could create a lower financial burden on health‐care systems. Level of Evidence 4 Technical Efficacy Stage 6

show abstract

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

Cited by 85 publications

References 26 publications

Biparametric MRI of the prostate

Biparametric MRI of the prostate

Biparametric vs multiparametric prostate magnetic resonance imaging for the detection of prostate cancer in treatment‐naïve patients: a diagnostic test accuracy systematic review and meta‐analysis

Comparison of Multiparametric and Fast MRI Protocols in Detecting Clinically Significant Prostate Cancer and a Detailed Cost Analysis

Contact Info

Product

Resources

About