Abstract
Objective
To evaluate the performance of a rapid, low cost, noncontrast MRI examination as a
secondary screening tool in detection of clinically significant prostate cancer.
Methods
In this prospective single institution study, 129 patients with elevated prostate-specific
antigen levels or abnormal digital rectal examination findings underwent MRI with
an abbreviated biparamatric MRI protocol consisting of high-resolution axial T2- and
diffusion-weighted images. Index lesions were classified according to modified Prostate
Imaging – Reporting and Data System (mPI-RADS) version 2.0. All patients underwent
standard transrectal ultrasound-guided biopsy after MRI with the urologist being blinded
to MRI results. Subsequently, all patients with suspicious lesions (mPI-RADS 3, 4,
or 5) underwent cognitively guided targeted biopsy after discussion of MRI results
with the urologist. Sensitivity and negative predictive value for identification of
clinically significant prostate cancer (Gleason score 3+4 and above) were determined.
Results
Rapid biparametric MRI discovered 176 lesions identified in 129 patients. Rapid MRI
detected clinically significant cancers with a sensitivity of 95.1% with a negative
predictive value of 95.1% and positive predictive value of 53.2%, leading to a change
in management in 10.8% of the patients. False negative rate of biparametric (bp) MRI
was 4.7%.
Conclusion
We found that a bp-MRI examination can detect clinically significant lesions and changed
patient management in 10.8% of the patients. A rapid MRI protocol can be used as a
useful secondary screening tool in men presenting with suspicion of prostate cancer.
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Article info
Publication history
Published online: September 07, 2018
Accepted:
August 22,
2018
Received in revised form:
August 20,
2018
Received:
July 16,
2018
Footnotes
Financial Disclosure: This study was supported by Siemens Healthineers and grants from NIH (NIH 1R01EB016728-01A1 and NIH 5R01EB017219-02). Siemens Healthineers had no influence on the study design, sequence selection, or interpretation of the results. None of the authors declares a conflict of interest related to this manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
