Magnetic resonance imaging of the prostate and targeted biopsy, Comparison of PIRADS and Gleason grading

Bastian-Jordan, Matthew

doi:10.1111/1754-9485.12678

Cited by 29 publications

(28 citation statements)

References 8 publications

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“…7,16,17,20 The CDR decreases to 42% when focusing only on clinically significant PCa. 25 Following this lead, the present results showed a higher probability of finding PCa with an elevated Gleason score in the case of PI-RADS 4 or 5. This definition varies greatly between studies, reflecting the uncertainty of identifying the determinants of cancer progression on biopsy.…”

Section: Discussionsupporting

confidence: 68%

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

et al. 2018

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Objectives To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice. Methods We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2–4) and random cores (usually 10–14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables. Results The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate‐specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer. Conclusions Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate‐specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate.

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Section: Discussionsupporting

confidence: 68%

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

et al. 2018

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“…On the other hand, an alternative clinical approach is to begin with mpMRI to determine which patients need a targeted biopsy (21,22). The detection rate of csPCa is directly related to the PI-RADS score (Table II) (11,(23)(24)(25)(26)(27)(28)(29)(30) and the results depend on clinical parameters, the number of previous negative biopsies and the quality of TPBx procedures; in a previous series, we reported a percentage of missed csPCa equal to 8.7 versus 23.5 versus 16.2 versus 0% in the presence of a PI-RAS score <3 versus 3 versus 4 versus 5 in patients that were diagnosed by transperineal SPBx (11). In addition, it is still unclear when and which mpMRI lesions negative for cancer should be submitted early to repeat TPBx; in this respect, about 15-20% of PI-RADS 3 could harbour a csPCa resulting in reclassification to PIRADS score 4 in a year (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is still unclear when and which mpMRI lesions negative for cancer should be submitted early to repeat TPBx; in this respect, about 15-20% of PI-RADS 3 could harbour a csPCa resulting in reclassification to PIRADS score 4 in a year (24,25). On the other hand, the detection rate of csPCa in the presence of PI-RADS score 5 versus 4 is extremely variable ranging from 35.6-100% (11,26) to 34-62.7% (23)(24)(25)(26)(27) of the cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

Early Second Round Targeted Biopsy of PI-RADS Score 3 or 4 in 256 Men With Persistent Suspicion of Prostate Cancer

Pepe

Garufi

Priolo

et al. 2019

In Vivo

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“…This correlation supports the concept of utilizing these data to potentially reduce sampling error and improve diagnostic accuracy of targeted biopsy. Current prostatic biopsy is often performed blind, although MRI directed biopsy based on Prostate Imaging Reporting and Data System (PI-RADS) is being increasingly utilized [ 83 , 84 , 85 , 86 ]. The addition of 68 Ga-PSMA PET/MRI may further improve the utility and accuracy of this technique and direct biopsy to the most relevant area within the prostate.…”

Section: New Clinical Applicationsmentioning

confidence: 99%

Review of Gallium-68 PSMA PET/CT Imaging in the Management of Prostate Cancer

Meyrick²,

2018

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Over 90% of prostate cancers over-express prostate specific membrane antigen (PSMA) and these tumor cells may be accurately targeted for diagnosis by 68Ga-PSMA-positron emission tomography/computed tomography (68Ga-PSMA-PET/CT) imaging. This novel molecular imaging modality appears clinically to have superseded CT, and appears superior to MR imaging, for the detection of metastatic disease. 68Ga-PSMA PET/CT has the ability to reliably stage prostate cancer at presentation and can help inform an optimal treatment approach. Novel diagnostic applications of 68Ga-PSMA PET/CT include guiding biopsy to improve sampling accuracy, and guiding surgery and radiotherapy. In addition to facilitating the management of metastatic castrate resistant prostate cancer (mCRPC), 68Ga-PSMA can select patients who may benefit from targeted systemic radionuclide therapy. 68Ga-PSMA is the diagnostic positron-emitting theranostic pair with the beta emitter Lutetium-177 PSMA (177Lu-PSMA) and alpha-emitter Actinium-225 PSMA (225Ac-PSMA) which can both be used to treat PSMA-avid metastases of prostate cancer in the molecular tumor-targeted approach of theranostic nuclear oncology.

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Magnetic resonance imaging of the prostate and targeted biopsy, Comparison of PIRADS and Gleason grading

Abstract: This paper demonstrates the incidence of CSD for different PIRADS grades. The low incidence of CSD in PIRADS 3 lesions suggests that in low clinical risk men, follow up in priority to biopsy may be an alternative treatment pathway.

Cited by 29 publications

References 8 publications

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

Early Second Round Targeted Biopsy of PI-RADS Score 3 or 4 in 256 Men With Persistent Suspicion of Prostate Cancer

Review of Gallium-68 PSMA PET/CT Imaging in the Management of Prostate Cancer

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