Universität zu Köln

Hansen, N. L., Koo, B. C., Warren, A. Y., Kastner, C. and Barrett, T. (2017). Sub-differentiating equivocal PI-RADS-3 lesions in multiparametric magnetic resonance imaging of the prostate to improve cancer detection. Eur. J. Radiol., 95. S. 307 - 314. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: To evaluate sub-differentiation of PI-RADS-3 prostate lesions using pre-defined T2-and diffusion weighted (DWI) MRI criteria, to aid the biopsy decision process. Methods: 143 patients with PIRADS-3 index lesions on MRI underwent targeted transperineal-MR/US fusion biopsy. Radiologists with 2 and 7-years experience performed blinded retrospective second-reads using set criteria and assigned biopsy recommendations. Inter-reader agreement, Gleason score (GS), positive (PPV) predictive values (95% confidence intervals) were calculated and compared by Fisher's exact test with Bonferroni-Hom correction. Results: 43% (61/143) patients had GS 6-10 and 21% (30/143) GS 3 + 4 cancer. For peripheral zone lesions, significant differences in any cancer detection were found for shape (0.26 +/- 0.13 geographical vs. 0.69 0.23 rounded; p = 0.0055) and ADC (mild 0.21 +/- 0.12 vs marked 0.81 +/- 0.19; p = 0.0001). For transition zone, significantly increased cancer detection was shown for location (anterior 0.63 +/- 0.15 vs. mid/posterior 0.31 +/- 0.14; p = 0.0048), border (pseudo-capsule 0.32 +/- 0.14 vs. ill-defined 0.61 +/- 0.15; p = 0.0092), and ADC (mild 0.35 +/- 0.12 vs marked restriction 0.68 +/- 0.17; p = 0.0057). Biopsy recommendations had 62% inter-reader agreement (89/143). Experienced reader PPVs were significantly higher for any cancer with biopsy-recommended 0.61 +/- 0.11 vs. no biopsy 0.21 +/- 0.10 (p = 0.0001), and for GS 7-10 cancers: 0.32 +/- 0.10 vs. 0.08 +/- 0.07, respectively (p = 0.0003). Conclusion: Identification of certain objective imaging criteria as well as a subjective biopsy recommendation from an experienced radiologist can help to increase the predictive value of equivocal prostate lesions and inform the decision making process of whether or not to biopsy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hansen, N. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koo, B. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Warren, A. Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kastner, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Barrett, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-215407
DOI:	10.1016/j.ejrad.2017.08.017
Journal or Publication Title:	Eur. J. Radiol.
Volume:	95
Page Range:	S. 307 - 314
Date:	2017
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADS VERSION 2; SCORING SYSTEM; MRI; BIOPSY; TUMOR Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21540