Objective
To determine the negative predictive value of multiparametric magnetic resonance imaging
(mpMRI), we evaluated the frequency of prostate cancer detection by 12-core template
mapping biopsy in men whose mpMRI showed no suspicious regions.
Methods
Six hundred seventy patients underwent mpMRI followed by transrectal ultrasound (TRUS)-guided
systematic prostate biopsy from December 2012 to June 2016. Of this cohort, 100 patients
had a negative mpMRI. mpMRI imaging sequences included T2-weighted and diffusion-weighted
imaging, and dynamic contrast enhancement sequences.
Results
The mean age, prostate-specific antigen, and prostate volume of the 100 men included
were 64.3 years, 7.2 ng/mL, and 71 mL, respectively. Overall cancer detection was
27% (27 of 100). Prostate cancer was detected in 26.3% (10 of 38) of patients who
were biopsy-naïve, 12.1% (4 of 33) of patients who had a prior negative biopsy, and
in 44.8% (13 of 29) of patients previously on active surveillance; Gleason grade ≥7
was detected in 3% of patients overall (3 of 100). The negative predictive value of
a negative mpMRI was 73% for all prostate cancer and 97% for Gleason ≥7 prostate cancer.
Conclusion
There is an approximately 3% chance of detecting clinically significant prostate cancer
with systematic TRUS-guided biopsy in patients with no suspicious findings on mpMRI.
This information should help guide recommendations to patients about undergoing systematic
TRUS-guided biopsy when mpMRI is negative.
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Article info
Publication history
Published online: March 18, 2017
Accepted:
January 8,
2017
Received:
September 25,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
Published by Elsevier Inc.
