Comparison of Multiparametric and Biparametric MRI in First Round Cognitive Targeted Prostate Biopsy in Patients with PSA Levels under 10 ng/mL

Abstract

PurposeTo determine the efficacy of cognitive targeted prostate biopsy using biparametric magnetic resonance imaging (b-MRI) for patients with prostate-specific antigen levels under 10 ng/mL.Materials and MethodsWe reviewed data from 123 consecutive patients who underwent cognitive targeted prostate biopsy using prostate MRI. Of these patients, the first 55 underwent prostate biopsy using multiparametric MRI (mp-MRI), and the remaining 68 underwent prostate biopsy using b-MRI. For b-MRI, we generated T2 weighted axial imaging and diffusion-weighted imaging sequences. We found that 62 of the 123 men had suspicious lesions on MRI (32 of the 55 men in the mp-MRI group and 30 of the 68 men in the b-MRI group). We compared the prostate cancer detection rates and the proportions of clinically significant prostate cancer between the different MRI sequences.ResultsBetween the two MRI groups, there were no statistically significant differences in prostate cancer detection rate and proportions of clinically significant prostate cancer (41.8% vs. 30.9%, p=0.208 and 82.6% vs. 76.2%, p=0.598). Among the 62 men who had suspicious lesions on MRI, the prostate cancer detection rates were 62.5% and 63.3% (p=0.709) in the mp-MRI and b-MRI groups, respectively, and the proportions of clinically significant prostate cancer were 95.0% and 84.2% (p=0.267).ConclusionProstate biopsy using b-MRI showed similar performance to that using mp-MRI for detecting prostate cancer and clinically significant prostate cancer. Considering the satisfactory performance and cost effectiveness of b-MRI, this technique could be a good option for obtaining intraprostatic information for first round prostate biopsy.

Factors Influencing Variability in the Performance of Multiparametric Magnetic Resonance Imaging in Detecting Clinically Significant Prostate Cancer: A Systematic Literature Review

“…Thestrup et al [83] reported similar accuracies of bpMRI and mpMRI in detecting csPCa, although without providing any formal statistical comparisons. Lee et al [84] compared two cohorts undergoing mpMRI and bpMRI for a suspicion of PCa and then receiving visual MRI-TBx in addition to standard systematic biopsy. The authors reported a similar detection of csPCa among men who had suspicious lesions in the bpMRI and mpMRI groups (63% and 62%, respectively).…”

Usefulness of Bi-Parametric Magnetic Resonance Imaging with b=1,800 s/mm2 Diffusion-Weighted Imaging for Diagnosing Clinically Significant Prostate Cancer

“…As we described in the previous studies, the overall detection rates of csPCa were not different between the mpMRI and bpMRI [17]. In addition, several studies used simple bpMRI for cost-effectiveness [15,[17][18][19]. bpMRI avoids additional cost, acquisition time, and side effects caused by contrast media.…”

Short review of biparametric prostate MRI

“…found 11.9 min scanning time (and 15.7 min table time) for bpMRI and ±45 min for mpMRI [9]. This was confirmed by Dong Hoon Lee et al., who found an in-bore time of 15 min for bpMRI and 45 min for mpMRI [10]. Other authors found considerably shorter time differences between mpMRI and bpMRI.…”

“…reported additional costs of about € 56 for a 70-kg patient only for the contrast agent [11]. A Korean group calculated costs of about $ 600 for mpMRI and only $ 300 for bmMRI [10].…”