Prostatic Biopsy Directed with Endorectal MR Spectroscopic Imaging Findings in Patients with Elevated Prostate Specific Antigen Levels and Prior Negative Biopsy Findings: Early Experience

Prando, Adilson; Kurhanewicz, John; Borges, Alexandre P.; Oliveira, Eduardo Morato de; Figueiredo, Eduardo

doi:10.1148/radiol.2363040615

Cited by 148 publications

(99 citation statements)

References 24 publications

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“…Proton MR spectroscopy is an alternative method with a high detection rate for diagnosing prostate cancer (15,16); however, the best results are only achieved with modern equipment and a longer acquisition time. In contrast to this method, DWI has the advantages of needing only short image acquisition times and technicians with less training.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer detection with magnetic resonance imaging: is dynamic contrast-enhanced imaging necessary in addition to diffusion-weighted imaging?

Iwazawa

Mitani²,

Sassa³

et al. 2010

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

Prostate cancer detection with magnetic resonance imaging: is dynamic contrast-enhanced imaging necessary in addition to diffusion-weighted imaging?

Iwazawa

Mitani²,

Sassa³

et al. 2010

Diagn Interv Radiol

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“…An accuracy of 67% has been reported for this method by means of spectroscopy and T 2 -weighted images [15]. Suboptimal image fusion due to different configurations of the endorectal balloon and the ultrasound transducer and consecutive different deformation of the prostate gland have been described as a main disadvantage [16].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Structured Report of Functional Prostate Magnetic Resonance Imaging in Patients with Suspicion for Prostate Cancer or under Active Surveillance

Quentin

Blondin²,

Klasen³

et al. 2012

Urol Int

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Background: Functional magnetic resonance imaging (MRI) seems to be a useful tool for prostate cancer (PCa) detection in patients with a previous negative biopsy but persistently increased prostate-specific antigen (PSA) values. Additionally, it enables correct cancer localization in patients with known PCa under active surveillance to avoid misclassification on repeat biopsies. Nevertheless, suspicious lesions on MRI findings need verification by biopsy. The aim of the present study was to establish a standardized functional prostate MRI reporting scheme. Methods: Prostate MRI with T₂-weighted images, T₁-weighted images, diffusion-weighted imaging, and dynamic contrast-enhanced MRI of 56 consecutive patients were performed on a 3-T scanner. Patients with prior negative random transrectal ultrasound (TRUS)-guided biopsy and continuous suspicion for PCa as well as patients under active surveillance were included. The MRI localization report of suspicious lesions followed a standardized scheme. TRUS-guided random biopsy with addition of targeted biopsy cores was performed afterwards based on the structured report. Results: Of the 56 patients, 18 had suspicious MRI findings and subsequently underwent repeat biopsy under guidance of the standardized localization scheme. PCa was documented in 72% (13/18). Conclusions: A standardized reporting scheme of suspicious findings on prostate MRI leads to higher success rates as compared to standard random TRUS-guided biopsy.

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“…Multiparametric evaluation is a combination of conventional endorectal T2-weighted image, spectroscopy, diffusion-weighted image and perfusion study (dynamic contrast-enhanced MRI). Using only MRI and MRSI results to target an endorectal sonographically guided biopsy in men with highly suspicious spectral trace for prostate cancer the sensitivity, specificity, positive and negative predictive values, and accuracy were 71%, 84%, 75%, 81%, and 79%, respectively (2). In this group of patients with at least two negative biopsies the finding of more than one focal area with low-signal intensity on T2-weighted image, suspicious for cancer, is not infrequent.…”

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confidence: 83%

Imaging

Prando¹

2009

Int. braz j urol.

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Purpose: To determine the incremental benefit of combined endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging, as compared with endorectal MR imaging alone, for sextant localization of peripheral zone (PZ) prostate cancer. Materials and Methods: This prospective multicenter study, conducted by the American College of Radiology Imaging Network (ACRIN) from February 2004 to June 2005, was institutional review board approved and HIPAA compliant. Research associates were required to follow consent guidelines approved by the Office for Human Research Protection and established by the institutional review boards. One hundred thirty-four patients with biopsy-proved prostate adenocarcinoma and scheduled to undergo radical prostatectomy were recruited at seven institutions. T1-weighted, T2-weighted, and spectroscopic MR sequences were performed at 1.5 T by using a pelvic phased-array coil in combination with an endorectal coil. Eight readers independently rated the likelihood of the presence of PZ cancer in each sextant by using a five-point scale-first on MR images alone and later on combined MR-MR spectroscopic images. Areas under the receiver operating characteristic curve (AUCs) were calculated with sextant as the unit of analysis. The presence or absence of cancer at centralized histopathologic evaluation of prostate specimens was the reference standard. Reader-specific receiver operating characteristic curves for values obtained with MR imaging alone and with combined MR imaging-MR spectroscopic imaging were developed. The AUCs were estimated by using Mann-Whitney statistics and appropriate 95% confidence intervals. Results: Complete data were available for 110 patients (mean age, 58 years; range, 45-72 years). MR imaging alone and combined MR imaging-MR spectroscopic imaging had similar accuracy in PZ cancer localization (AUC, 0.60 vs. 0.58, respectively; P > .05). AUCs for individual readers were 0.57-0.63 for MR imaging alone and 0.54-0.61 for combined MR imaging-MR spectroscopic imaging. Conclusion: In patients who undergo radical prostatectomy, the accuracy of combined 1.5-T endorectal MR imaging-MR spectroscopic imaging for sextant localization of PZ prostate cancer is equal to that of MR imaging alone. Editorial CommentEndorectal prostate cancer imaging protocols remain subject of much debate, and undergo continuous evaluation and review. The results of this multi-institutional trial showed that magnetic resonance spectroscopic imaging (MRSI) shows no advantages over conventional magnetic resonance imaging (MRI) alone, for localization of peripheral zone prostate cancer. Similarly to other radiologic centers, since 2005, combined conventional endorectal MRI + MRSI has become routinely practice in our institution, in two main clinical situations. First, in the preoperative staging work-up for patients with moderate or high risk of extraprostatic extension and second in patients with negative biopsies and elevated or rising PSA.Patients without signs of extraprostatic extension on conventio...

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Prostatic Biopsy Directed with Endorectal MR Spectroscopic Imaging Findings in Patients with Elevated Prostate Specific Antigen Levels and Prior Negative Biopsy Findings: Early Experience

Abstract: Metabolic data from MR spectroscopic imaging can be transferred to transrectal US images and used to sample regions of cancer in men with rising PSA levels and negative findings at prior biopsy with good accuracy.

Cited by 148 publications

References 24 publications

Prostate cancer detection with magnetic resonance imaging: is dynamic contrast-enhanced imaging necessary in addition to diffusion-weighted imaging?

Prostate cancer detection with magnetic resonance imaging: is dynamic contrast-enhanced imaging necessary in addition to diffusion-weighted imaging?

Evaluation of a Structured Report of Functional Prostate Magnetic Resonance Imaging in Patients with Suspicion for Prostate Cancer or under Active Surveillance

Imaging

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