3.0 T multiparametric prostate MRI using pelvic phased-array coil: Utility for tumor detection prior to biopsy

Andrew B. Rosenkrantz, Thais C. Mussi, Michael S. Borofsky, Stephen S. Scionti, Michael Grasso, Samir S. Taneja

    Research output: Contribution to journalArticle

    Abstract

    Objective: To evaluate the role of multiparametric magnetic resonance imaging (MRI) performed in men without a biopsy-proven diagnosis of prostate cancer using follow-up biopsy as the reference standard. Materials and methods: Forty-two patients without biopsy-proven cancer and who underwent MRI were included. In all patients, MRI was performed at 3T using a pelvic phased-array coil and included T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging. Thirteen had undergone no previous biopsy, and 29 had undergone at least 1 previous negative biopsy. All patients underwent prostate biopsy following MRI. Two fellowship-trained radiologists in consensus reviewed all cases and categorized each lobe as positive or negative for tumor. These interpretations were correlated with findings on post-MRI biopsy. Results: Follow-up biopsy was positive in 23 lobes in 15 patients (36% of study cohort). On a per-patient basis, MRI had a sensitivity of 100%, specificity of 74%, positive predictive value (PPV) of 68%, and negative predictive value (NPV) of 100%. On a per-lobe basis, MRI had a sensitivity of 65%, specificity of 84%, PPV of 60%, and NPV of 86%. There was a nearly significant association between Gleason score and tumor detection on MRI (P = 0.072). Conclusions: In our sample, MRI had 100% sensitivity in predicting the presence of tumor on subsequent biopsy on a per-patient basis, suggesting a possible role for MRI in selecting patients with an elevated prostatic specific antigen (PSA) to undergo prostate biopsy. However, MRI had weaker specificity for prediction of a subsequent positive biopsy, as well as weaker sensitivity for tumor on a per-lobe basis, indicating that in patients with a positive MRI result, tissue sampling remains necessary for confirmation of the diagnosis as well as for treatment planning.

    Original languageEnglish (US)
    Pages (from-to)1430-1435
    Number of pages6
    JournalUrologic Oncology: Seminars and Original Investigations
    Volume31
    Issue number8
    DOIs
    StatePublished - Nov 2013

    Keywords

    • Biopsy
    • MRI
    • Prostate cancer

    ASJC Scopus subject areas

    • Oncology
    • Urology

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