Diagnostic value of 3.0 T versus 1.5 T MRI in staging prostate cancer: systematic review and meta-analysis

Virarkar, Mayur; Szklaruk, Janio; Diab, Radwan; Bassett, Roland; Bhosale, Priya

doi:10.5114/pjr.2022.118685

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…For advanced cancer, reported confidence was up to 99% in comparison to 87-97% reported for mp-MRI [74]. As PET PSMA gains increasing attention and influences treatment change in patients previously diagnosed with MR [75,76], there is a need to improve diagnostic techniques based on mp-MRI, especially in regard to the performance of 1.5 T scanners, as obtained results are less significant compared to those presented by 3T scanners [77,78].…”

Section: Discussionmentioning

confidence: 93%

Textural Features of MR Images Correlate with an Increased Risk of Clinically Significant Cancer in Patients with High PSA Levels

Gibała¹,

Obuchowicz

Lasek

et al. 2023

JCM

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Background: Prostate cancer, which is associated with gland biology and also with environmental risks, is a serious clinical problem in the male population worldwide. Important progress has been made in the diagnostic and clinical setups designed for the detection of prostate cancer, with a multiparametric magnetic resonance diagnostic process based on the PIRADS protocol playing a key role. This method relies on image evaluation by an imaging specialist. The medical community has expressed its desire for image analysis techniques that can detect important image features that may indicate cancer risk. Methods: Anonymized scans of 41 patients with laboratory diagnosed PSA levels who were routinely scanned for prostate cancer were used. The peripheral and central zones of the prostate were depicted manually with demarcation of suspected tumor foci under medical supervision. More than 7000 textural features in the marked regions were calculated using MaZda software. Then, these 7000 features were used to perform region parameterization. Statistical analyses were performed to find correlations with PSA-level-based diagnosis that might be used to distinguish suspected (different) lesions. Further multiparametrical analysis using MIL-SVM machine learning was used to obtain greater accuracy. Results: Multiparametric classification using MIL-SVM allowed us to reach 92% accuracy. Conclusions: There is an important correlation between the textural parameters of MRI prostate images made using the PIRADS MR protocol with PSA levels > 4 mg/mL. The correlations found express dependence between image features with high cancer markers and hence the cancer risk.

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Section: Discussionmentioning

confidence: 93%

Textural Features of MR Images Correlate with an Increased Risk of Clinically Significant Cancer in Patients with High PSA Levels

Gibała¹,

Obuchowicz

Lasek

et al. 2023

JCM

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“…Lastly, due to each center’s available MRI machines, either 1.5 or 3 T MRI was used; this has not been found to significantly affect its diagnostic performance in PCa staging. 29…”

Section: Discussionmentioning

confidence: 99%

Prostate Health Index Density Outperforms Prostate-specific Antigen Density in the Diagnosis of Clinically Significant Prostate Cancer in Equivocal Magnetic Resonance Imaging of the Prostate: A Multicenter Evaluation

et al. 2023

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Purpose:We compare Prostate Health Index, Prostate Health Index density, and PSA density in predicting clinically significant prostate cancer in MRI-guided prostate biopsy.Materials and Methods:This is a multicenter evaluation of prospectively maintained prostate biopsy databases at 10 urology centers. Men with Prostate Health Index and MRI-guided targeted and systematic prostate biopsy performed and without prior prostate cancer diagnosis were included. The additional value of PSA density, Prostate Health Index, and Prostate Health Index density to MRI PI-RADS (Prostate Imaging Reporting & Data System) score was evaluated with multivariable analyses, area under the curve, and decision curve analyses. The proportion of unnecessary biopsies that can be avoided are estimated for clinically significant prostate cancer (International Society of Urological Pathology group ≥2 prostate cancer).Results:A total of 1,215 men were analyzed. Prostate cancer and clinically significant prostate cancer were diagnosed in 51% (617/1,215) and 35% (422/1,215) of men, respectively. Clinically significant prostate cancer was diagnosed in 4.4% (3/68), 15% (72/470), 39% (176/446), and 74% (171/231) of highest PI-RADS score of 2, 3, 4, and 5 lesions, respectively. In multivariable analyses, independent predictors for clinically significant prostate cancer detection included Prostate Health Index (OR 1.04), prostate volume (OR 0.97), and PI-RADS score 4 (OR 2.81) and 5 (OR 8.34). Area under the curve for clinically significant prostate cancer of PI-RADS + Prostate Health Index density (0.85) was superior to PI-RADS + PSA density (0.81), Prostate Health Index density (0.81), Prostate Health Index (0.78), PI-RADS (0.76), PSA density (0.72), and PSA (0.60) in the whole cohort, and the superiority of Prostate Health Index density was also observed in PI-RADS 3 lesions. Decision curve analysis showed Prostate Health Index density achieving the best net clinical benefit in PI-RADS 3 or 4 cases. Among PI-RADS 3 lesions, using cutoffs of PSA density 0.15, Prostate Health Index 38.0, and Prostate Health Index density 0.83 could reduce 58%, 67%, and 72% of unnecessary biopsies, respectively.Conclusions:Prostate Health Index density outperformed Prostate Health Index or PSA density in clinically significant prostate cancer detection in men with multiparametric MRI performed, and further reduced unnecessary biopsies in PI-RADS 3 lesions.

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“…[5] However, a recent metaanalysis emphasized that 1.5T and 3T MRI do not differ statistically in diagnostic performance. [15] Among previous publications applying PI-RADS v2. target lesion located at the PZ in a 3T MRI showed a 32.6% DR for csPCa in the prostate PZ among all PI-RADS categories.…”

Section: Discussionmentioning

confidence: 99%

Clinical implementation PI-RADS v2.1: Detection rate of clinically significant prostate cancer in PI-RADS 4 and 5 categories–The Real-life data

Tirtashi

Tamaskani

Salamat

et al. 2023

Preprint

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Background Clinically significant prostate cancer (csPCa) diagnosis and risk assessment have been improved after utilizing multiparametric magnetic resonance imaging (mp-MRI). To access the global standardization in mp-MRI acquisition and interpretation, Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) was developed and showed good overall performance in the detection of csPCa, particularly among higher categories. This study aimed to identify the csPCa detection rate (DR) among PI-RADS 4 and 5 categories. Methods The study population includes 76 (109 lesions) biopsy naïve patients with PI-RADS scores of 4 and 5 in prebiopsy mp-MRI who underwent systematic biopsy combined with cognitive targeted biopsy (cog-MRGB) between March 2020 and September 2022. Baseline characteristics and pathological findings were compared based on csPCa and PI-RADS scores. In addition, prostate cancer (PCa) and csPCa DRs were determined overall and according to the PI-RADS categories and the prostate zones. Results Among the study population, 35 men (46.10%) (51 lesions) and 41 men (53.90%) (58 lesions) belonged to PI-RADS scores of 4 and 5, respectively. The age of participants was 68.74 years in mean (with a standard deviation [SD] 8.83). Moreover, the level of prostate-specific antigen (PSA) was 9.47 ng/ml in the median (interquartile range [IQR] 6.20-19.79), along with the median prostate volume of 45.50 (IQR 35.00–76.00) ml. Individuals suffering from csPCa had statistically significant higher levels of PSA, PI-RADS categories, and lesions located on the prostate peripheral zone (PZ), as well as larger lesions and smaller prostate. The overall PCa and csPCa DRs were 57.90% (44 patients) and 44.70% (34 patients). Furthermore, csPCa DR stratified by PI-RADS scores and prostate zones was 68.30% in PI-RADS 5, 17.10% in PI-RADS 4, 54.90% in the PZ, and 34.30% in the prostate transition zone (TZ). Conclusions Our real-life data from a Middle Eastern developing country showed that the clinical implementation of PI-RADS v2.1 in combination with cog-MRGB yielded an acceptable overall PCa and csPCa DR, particularly among PI-RADS scores of 5. However, the results provided notable limitations on the PI-RADS score of 4 and TZ.

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Diagnostic value of 3.0 T versus 1.5 T MRI in staging prostate cancer: systematic review and meta-analysis

Cited by 7 publications

References 24 publications

Textural Features of MR Images Correlate with an Increased Risk of Clinically Significant Cancer in Patients with High PSA Levels

Textural Features of MR Images Correlate with an Increased Risk of Clinically Significant Cancer in Patients with High PSA Levels

Prostate Health Index Density Outperforms Prostate-specific Antigen Density in the Diagnosis of Clinically Significant Prostate Cancer in Equivocal Magnetic Resonance Imaging of the Prostate: A Multicenter Evaluation

Clinical implementation PI-RADS v2.1: Detection rate of clinically significant prostate cancer in PI-RADS 4 and 5 categories–The Real-life data

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