Multiparametric Magnetic Resonance Imaging Grades the Aggressiveness of Prostate Cancer

Morote, Juan; Borque‐Fernando, Ángel; Triquell, Marina; Celma, A.; Regis, Lucas; Mast, Richard; Torres, Inés M. de; Semidey, María Eugenia; Santamaría, Anna; Planas, Jacques; Esteban, Luis; Trilla, Enrique

doi:10.3390/cancers14071828

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…Numerous studies in the literature investigated the relationship between PI-RADS categories and various prognostic factors. Morote et al 32 demonstrated the association between the PI-RADS group and PCa aggressiveness. Similar to our study, Morote et al’s 32 work also found that the PI-RADS ≥4 patient group was significantly more associated with aggressive cancers compared to the PI-RADS ≤3 group.…”

Section: Discussionmentioning

confidence: 99%

“…Morote et al 32 demonstrated the association between the PI-RADS group and PCa aggressiveness. Similar to our study, Morote et al’s 32 work also found that the PI-RADS ≥4 patient group was significantly more associated with aggressive cancers compared to the PI-RADS ≤3 group. Alessi et al 33 reported that a low PI-RADS score (PI-RADS ≤3) independently excluded the presence of extraprostatic extension with a sensitivity of 99% and a negative predictive value of 98%, irrespective of clinical risk group.…”

Section: Discussionmentioning

confidence: 99%

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Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Önder,

Ayva,

Yaraşır

et al. 2024

dir

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PURPOSE We aim to examine the long-term outcomes of patients who underwent multiparametric prostate magnetic resonance imaging (mp-MRI) for suspected prostate cancer (PCa), specifically based on their initial Prostate Imaging Reporting and Data System (PI-RADS) categories and various clinical factors. Our secondary aim is to evaluate the prognostic value of the PI-RADS through the National Comprehensive Cancer Network (NCCN) risk group distribution. METHODS This research was conducted as a single-center retrospective cohort study in a tertiary care hospital. A total of 1,359 cases having at least one histopathological examination after the initial mp-MRI and/or adequate clinical/radiological follow-up data were included in the clinically significant PCa (cs-PCa) diagnosis-free survival analysis. Initial mp-MRI dates were accepted as the start of follow-up for the time-to-event analysis. The event was defined as cs-PCa diagnosis (International Society of Urological Pathology ≥2). Patients who were not diagnosed with cs-PCa during follow-up were censored according to predefined literature-based criteria at the end of the maximum follow-up duration with no reasonable suspicion of PCa and no biopsy indication. The impact of various factors on survival was assessed using a log-rank test and multivariable Cox regression. Subsequently, 394 cases diagnosed with PCa during follow-up were evaluated, based on initial PI-RADS categories and NCCN risk groups. RESULTS Three main risk factors for cs-PCa diagnosis during follow-up were an initial PI-RADS 5 category, initial PI-RADS 4 category, and high MRI-defined PSA density (mPSAD), with average hazard ratios of 29.52, 14.46, and 3.12, respectively. The PI-RADS 3 category, advanced age group, and biopsy-naïve status were identified as additional risk factors (hazard ratios: 2.03, 1.54–1.98, and 1.79, respectively). In the PI-RADS 1–2 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 99.1%, 96.5%, and 93.8%, respectively. For the PI-RADS 3 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 94.9%, 90.9%, and 89.1%, respectively. For the PI-RADS 4 cohort, 1, 3, and 5-year cs-PCa diagnosis-free survival rates were 56.6%, 55.1%, and 55.1%, respectively. These rates were found to all be 24.2% in the PI-RADS 5 cohort. Considering the 394 cases diagnosed with PCa during follow-up, PI-RADS ≥4 cases were more likely to harbor unfavorable PCa compared to PI-RADS ≤3 cases ( P < 0.001). In the PI-RADS 3 subgroup analysis, a low mPSAD (<0.15 ng/mL 2 ) was found to be a protective prognostic factor against unfavorable PCa ( P = 0.005). CONCLUSION The PI-RADS category has a significant impact on patient management and provides important diagnostic and prognostic information. Higher initial PI-RADS categories are associated with decreased follow-up losses, a shorter time to PCa ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Önder,

Ayva,

Yaraşır

et al. 2024

dir

View full text Add to dashboard Cite

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“…However, in the multivariable analysis, the cut-off value did not impact the cancer detection significantly. This may be due to the overall ambivalent detection rate of PI-RADS 3 that has been well documented in the literature [ 35 , 36 ]. The detection rate of csPCa for PI-RADS 3 was only 21/432 (10.4%) in our cohort and, therefore, the influence of factors, such as age or volume, might be underpowered in these cases.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Prostate Volume on the Prostate Imaging and Reporting Data System (PI-RADS) in a Real-World Setting

et al. 2023

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Multiparametric magnetic resonance imaging (mpMRI) has emerged as a new cornerstone in the diagnostic pathway of prostate cancer. However, mpMRI is not devoid of factors influencing its detection rate of clinically significant prostate cancer (csPCa). Amongst others, prostate volume has been demonstrated to influence the detection rates of csPCa. Particularly, increasing volume has been linked to a reduced cancer detection rate. However, information about the linkage between PI-RADS, prostate volume and detection rate is relatively sparse. Therefore, the current study aims to assess the association between prostate volume, PI-RADS score and detection rate of csP-Ca, representing daily practice and contemporary mpMRI expertise. Thus, 1039 consecutive patients with 1151 PI-RADS targets, who underwent mpMRI-guided prostate biopsy at our tertiary referral center, were included. Prior mpMRI had been assessed by a plethora of 111 radiology offices, including academic centers and private practices. mpMRI was not secondarily reviewed in house before biopsy. mpMRI-targeted biopsy was performed by a small group of a total of ten urologists, who had performed at least 100 previous biopsies. Using ROC analysis, we defined cut-off values of prostate volume for each PI-RADS score, where the detection rate drops significantly. For PI-RADS 4 lesions, we found a volume > 61.5 ccm significantly reduced the cancer detection rate (OR 0.24; 95% CI 0.16–0.38; p < 0.001). For PI-RADS 5 lesions, we found a volume > 51.5 ccm to significantly reduce the cancer detection rate (OR 0.39; 95% CI 0.25–0.62; p < 0.001). For PI-RADS 3 lesions, none of the evaluated clinical parameters had a significant impact on the detection rate of csPCa. In conclusion, we show that enlarged prostate volume represents a major limitation in the daily practice of mpMRI-targeted biopsy. This study is the first to define exact cut-off values of prostate volume to significantly impair the validity of PI-RADS assessed in a real-world setting. Therefore, the results of mpMRI-targeted biopsy should be interpreted carefully, especially in patients with prostate volumes above our defined thresholds.

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“…It was reported that could MRI only find morphological information and was not able to obtain the internal microstructure of tumor tissues, resulting in difficult evaluation for the risk of prostate tumors [ 6 ]. Another study showed that diffusion-weighted MRI could well manifest the tissue of tumor with abundant vascularity; however, the diagnostic role for prostate malignant tumor was debated [ 7 ]. In conclusion, MRI has the advantages of thorough research and clear morphological information and can better display tumor tissues with abundant blood vessels.…”

Section: Introductionmentioning

confidence: 99%

Study on the Diagnostic Value of Contrast-Enhanced Ultrasound and Magnetic Resonance Imaging in Prostate Cancer

Pang¹,

Zhang²,

Chen³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. The aim is to study the different roles of single and joint application of magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS) in prostate malignant tumors. Methods. 72 patients with prostate masses who underwent CEUS and MRI examination in our hospital from October 2021 and March 2022 were enrolled in this research. The differentially diagnostic roles of CEUS, MRI, and CEUS combined MRI for prostate cancer was assessed on basis of pathological findings as the reference standard. The specificity and sensitivity of the joint application for prostate malignant tumors with various prostate-specific antigen (PSA) levels were also evaluated. Results. The sensitivity of CEUS, MRI, and the joint application for prostate cancer were 72.1%, 74.4%, and 90.7%, respectively. Compared with single application, the sensitivity of CEUS combined with MRI was significantly higher. The specificity of MRI, CEUS, and the combination of the two for prostate cancer were 82.8%, 79.3%, and 89.7%, respectively, and the statistical differences for specificity were not found. The area under ROC curve (AUC) of CEUS combined with MRI in prostate malignant tumor diagnosis was obviously more than that of CEUS and MRI ( P < 0.05 ). CEUS combined with MRI has relative high sensitivity in these patients with different levels of PSA. Conclusions. Contrast-enhanced ultrasound combined with MRI can significantly improve the sensitivity and specificity of prostate cancer diagnosis so that patients can be better diagnosed in advance.

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Multiparametric Magnetic Resonance Imaging Grades the Aggressiveness of Prostate Cancer

Cited by 7 publications

References 27 publications

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

Long-term follow-up results of multiparametric prostate MRI and the prognostic value of PI-RADS: a single-center retrospective cohort study

The Impact of Prostate Volume on the Prostate Imaging and Reporting Data System (PI-RADS) in a Real-World Setting

Study on the Diagnostic Value of Contrast-Enhanced Ultrasound and Magnetic Resonance Imaging in Prostate Cancer

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