Diagnostic accuracy of biparametric versus multiparametric prostate MRI: assessment of contrast benefit in clinical practice.
Purpose: To assess the added value of dynamic contrast-enhanced (DCE) in prostate MR in clinical practice.Methods: Two hundred sixty-four patients underwent prostate MRI, with T2 and DWI sequences initially interpreted, prior to full multiparametric magnetic resonance imaging (mpMRI) interpretation...
| Publicado en: | European Radiology Vol. 30; no. 7; pp. 4039 - 4050 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143855666&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 143855666 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jul2020 vid: 30 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 143855666 143855666 143979314 NLM32166495 10.1007/s00330-020-06782-0 NLM32166495 143855666 ppf: 4039 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Diagnostic accuracy of biparametric versus multiparametric prostate MRI: assessment of contrast benefit in clinical practice. aug: au: Zawaideh, Jeries P. Sala, Evis Shaida, Nadeem Koo, Brendan Warren, Anne Y. Carmisciano, Luca Saeb-Parsy, Kasra Gnanapragasam, Vincent J. Kastner, Christof Barrett, Tristan affil: Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK sug: subj: Prostatic Neoplasms Magnetic Resonance Imaging Methods Contrast Media Administration and Dosage Middle Age Prospective Studies Retrospective Design Male Aged Aged, 80 and Over Adult Biopsy Prostatic Neoplasms Pathology Sensitivity and Specificity Scales Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Adult: 19-44 years Male ab: Purpose: To assess the added value of dynamic contrast-enhanced (DCE) in prostate MR in clinical practice.Methods: Two hundred sixty-four patients underwent prostate MRI, with T2 and DWI sequences initially interpreted, prior to full multiparametric magnetic resonance imaging (mpMRI) interpretation using a Likert 1-5 scale. A prospective opinion was given on likely benefit of contrast prior to review of the DCE sequence, and retrospectively following full mpMRI review. The final histology result following targeted and/or systematic biopsy of the prostate was used for outcome purposes.Results: Biparametric magnetic resonance imaging (bpMRI) and mpMRI were assigned the same score in 86% of cases; when dichotomising to a negative or positive MRI (Likert score ≥ 3), concordance increased to 92.8%. At Likert score ≥ 3 bpMRI detected 89.9% of all cancers and 93.5% clinically significant prostate cancers (csPCa) and mpMRI 90.7% and 94.6%, respectively. mpMRI had fewer false positives than bpMRI (11.4% vs 18.9%) and a lower Likert 3 rate (8.3% vs 17%), conferring higher specificity (74% vs 67%), but similar sensitivity (95% versus 94%) and ROC-AUC (90% vs 89%). At a positive MRI threshold of Likert ≥ 4, mpMRI had a higher sensitivity than bpMRI (89% versus 80%) and detected more csPCa (89.2% versus 79.6%). DCE was prospectively considered of potential benefit in 27.3%, but readers would only recall 11% of patients for DCE sequences, mainly to assess score 3 peripheral zone lesions. Following full mpMRI review, DCE was considered helpful in 28.4% of cases; in 23/75 (30.6%) of these cases this only became apparent after reviewing the sequence, reasons included increased confidence, presence of "safety-net" lesions or inflammatory lesions.Conclusion: BpMRI has equivalent cancer detection rates to mpMRI; however, mpMRI had fewer Likert 3 call rates and increased specificity and was subjectively considered of benefit by readers in 28.4% of cases.Key Points: • bpMRI has similar cancer detection rates to the full mpMRI protocol at a positive MRI threshold of Likert 3. • mpMRI had fewer intermediate category 3 calls (8.3%) than bpMRI (17%) and fewer false positives than bpMRI (11.4% vs 18.9%), conferring higher specificity (74% vs 67%). • Readers considered DCE beneficial in 28.4% of cases, but in a relatively high number (30.6%) this only became apparent after reviewing the sequence. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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