Cancer detection rate of prebiopsy MRI with subsequent systematic and targeted biopsy are superior to non-targeting systematic biopsy without MRI in biopsy naïve patients: a retrospective cohort study

Washino, Satoshi; Kobayashi, Shigeru; Okochi, Tomohisa; Kameda, Tomohiro; Konoshi, Tsuzumi; Miyagawa, Tomoaki; Takayama, Tadateru; Morita, Tatsuo

doi:10.1186/s12894-018-0361-4

Cited by 20 publications

(17 citation statements)

References 26 publications

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“…Our results are in line with previous studies that MRI followed by a targeted biopsy has a high negative predictive value for detection of clinically significant prostate cancers (26,27). In addition, the false negative rate was lower than 5%, which is in the same range as for mpMRI (6,28,29).…”

Section: Discussionmentioning

confidence: 54%

Diagnostic Accuracy of a Rapid Biparametric MRI Protocol for Detection of Histologically Proven Prostate Cancer

Obmann

Pahwa

Tabayayong

et al. 2018

Urology

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Section: Discussionmentioning

confidence: 54%

Diagnostic Accuracy of a Rapid Biparametric MRI Protocol for Detection of Histologically Proven Prostate Cancer

Obmann

Pahwa

Tabayayong

et al. 2018

Urology

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“…Traditionally, the decision about whether a prostate biopsy should be performed has been based mainly on PSA, digital rectal examination findings, and age, which leads to inaccurate results. 8 …”

Section: Discussionmentioning

confidence: 99%

“…Several studies report on the usefulness of mpMRI. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Porpiglia et al. 3 reported that a diagnostic pathway based on mpMRI had a higher detection rate than the standard approach for both PCa and clinically significant prostate cancer (csPCa).…”

Section: Introductionmentioning

confidence: 99%

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Detection of prostate cancer using prostate imaging reporting and data system score and prostate-specific antigen density in biopsy-naive and prior biopsy-negative patients

Ryoo

Kang

Sung

et al. 2020

Prostate International

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Background Few studies report on indications for prostate biopsy using Prostate Imaging–Reporting and Data System (PI-RADS) score and prostate-specific antigen density (PSAD). No study to date has included biopsy-naïve and prior biopsy-negative patients. Therefore, we evaluated the predictive values of the PI-RADS, version 2 (v2) score combined with PSAD to decrease unnecessary biopsies in biopsy-naïve and prior biopsy-negative patients. Materials and methods A total of 1,098 patients who underwent multiparametric magnetic resonance imaging at our hospital before a prostate biopsy and who underwent their second prostate biopsy with an initial benign negative prostatic biopsy were included. We found factors associated with clinically significant prostate cancer (csPca). We assessed negative predictive values by stratifying biopsy outcomes by prior biopsy history and PI-RADS score combined with PSAD. Results The median age was 65 years (interquartile range: 59-70), and the median PSA was 5.1 ng/mL (interquartile range: 3.8-7.1). Multivariate logistic regression analysis revealed that age, prostate volume, PSAD, and PI-RADS score were independent predictors of csPca. In a biopsy-naïve group, 4% with PI-RADS score 1 or 2 had csPca; in a prior biopsy-negative group, 3% with PI-RADS score 1 or 2 had csPca. The csPca detection rate was 2.0% for PSA density <0.15 ng/mL/mL and 4.0% for PSA density 0.15-0.3 ng/mL/mL among patients with PI-RADS score 3 in a biopsy-naïve group. The csPca detection rate was 1.8% for PSA density <0.15 ng/mL/mL and 0.15-0.3 ng/mL/mL among patients with PI-RADS score 3 in a prior biopsy-negative group. Conclusion Patients with PI-RADS v2 score ≤2, regardless of PSA density, may avoid unnecessary biopsy. Patients with PI-RADS score 3 may avoid unnecessary biopsy through PSA density results.

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“…Recent publications from the multicenter PROMIS and PRECISION trials have proven the value of mp‐MRI compared to targeted biopsy as an alternative to random biopsies in men with elevated PSA or abnormal DRE with increased significant cancer detection rates, less detection of insignificant cancers and in up to one‐third of men potentially obviating the need for biopsy altogether when mp‐MRI is negative. mp‐MRI before targeted biopsy in at‐risk men is rapidly becoming the standard of care in clinical practice …”

Section: Introductionmentioning

confidence: 99%

Automated segmentation of prostate zonal anatomy on T2‐weighted (T2W) and apparent diffusion coefficient (ADC) map MR images using U‐Nets

et al. 2019

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Purpose: Accurate regional segmentation of the prostate boundaries on magnetic resonance (MR) images is a fundamental requirement before automated prostate cancer diagnosis can be achieved. In this paper, we describe a novel methodology to segment prostate whole gland (WG), central gland (CG), and peripheral zone (PZ), where PZ + CG = WG, from T2W and apparent diffusion coefficient (ADC) map prostate MR images. Methods: We designed two similar models each made up of two U-Nets to delineate the WG, CG, and PZ from T2W and ADC map MR images, separately. The U-Net, which is a modified version of a fully convolutional neural network, includes contracting and expanding paths with convolutional, pooling, and upsampling layers. Pooling and upsampling layers help to capture and localize image features with a high spatial consistency. We used a dataset consisting of 225 patients (combining 153 and 72 patients with and without clinically significant prostate cancer) imaged with multiparametric MRI at 3 Tesla. Results and conclusion: Our proposed model for prostate zonal segmentation from T2W was trained and tested using 1154 and 1587 slices of 100 and 125 patients, respectively. Median of Dice similarity coefficient (DSC) on test dataset for prostate WG, CG, and PZ were 95.33 AE 7.77%, 93.75 AE 8.91%, and 86.78 AE 3.72%, respectively. Designed model for regional prostate delineation from ADC map images was trained and validated using 812 and 917 slices from 100 and 125 patients. This model yielded a median DSC of 92.09 AE 8.89%, 89.89 AE 10.69%, and 86.1 AE 9.56% for prostate WG, CG, and PZ on test samples, respectively. Further investigation indicated that the proposed algorithm reported high DSC for prostate WG segmentation from both T2W and ADC map MR images irrespective of WG size. In addition, segmentation accuracy in terms of DSC does not significantly vary among patients with or without significant tumors. Significance: We describe a method for automated prostate zonal segmentation using T2W and ADC map MR images independent of prostate size and the presence or absence of tumor. Our results are important in terms of clinical perspective as fully automated methods for ADC map images, which are considered as one of the most important sequences for prostate cancer detection in the PZ and CG, have not been reported previously.

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Cancer detection rate of prebiopsy MRI with subsequent systematic and targeted biopsy are superior to non-targeting systematic biopsy without MRI in biopsy naïve patients: a retrospective cohort study

Cited by 20 publications

References 26 publications

Diagnostic Accuracy of a Rapid Biparametric MRI Protocol for Detection of Histologically Proven Prostate Cancer

Diagnostic Accuracy of a Rapid Biparametric MRI Protocol for Detection of Histologically Proven Prostate Cancer

Detection of prostate cancer using prostate imaging reporting and data system score and prostate-specific antigen density in biopsy-naive and prior biopsy-negative patients

Automated segmentation of prostate zonal anatomy on T2‐weighted (T2W) and apparent diffusion coefficient (ADC) map MR images using U‐Nets

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