To compare the accuracy of multiple abbreviated multiparametric magnetic resonance imaging (mpMRI)-derived protocols in detecting clinically significant prostate cancer (csPCa).
108 men undergoing staging 3.
0T mpMRI with a Prostate Imaging - Reporting and Data System version 2 (PI-RADSv2)-compliant protocol before radical prostatectomy (RP) were retrospectively evaluated. Two readers (R1, R2) independently analyzed mpMRI, assigning a PI-RADSv2 category to each observation as appearing on each examination sequence. A study coordinator assessed final PI-RADSv2 category by combining readers' assignments according to four protocols: short MRI (sMRI) (diffusion-weighted imaging + axial T2-weighted imaging), contrast-enhanced short MRI (cesMRI) (sMRI + dynamic contrast-enhanced [DCE] imaging), biparametric MRI (diffusion-weighted imaging + multiplanar T2-weigthed imaging), and mpMRI. Using RP pathology as the reference standard for csPCa, we calculated the per-lesion cancer detection rate (CDR) and false discovery rate (FDR) for each MRI protocol (cutoff PI-RADSv2 category ≥3), and the per-PI-RADSv2 category prevalence of csPCa and false positives.
Pathology after RP found 142 csPCas with median International Society of Urogenital Pathology grade group 2, and stage ≤pT2c in 68.6% of cases. CDR was comparable across the four MRI protocols (74.6% to 75.3% for R1, and 68.3% for R2). FDR was comparable as well (14.4%-14.5% for R1 and 11.1% for R2). sMRI was the minimum protocol equaling mpMRI in terms of CDR, although cesMRI, similarly to mpMRI, was associated with fewer PI-RADSv2 category 3 assignments and higher prevalence of csPCa within PI-RADSv2 category 3 observations (66.7% versus 76.9% for R1, and 100% versus 91.7% for R2, respectively).
Among multiple abbreviated mpMRI-derived protocols, cesMRI was the one equaling mpMRI in terms of csPCa detection and minimizing PI-RADSv2 category 3 assignments.
Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2020 Oct 05 [Epub ahead of print]
Lorenzo Cereser, Gianluca Giannarini, Filippo Bonato, Stefano Pizzolitto, Giuseppe Como, Claudio Valotto, Vincenzo Ficarra, Fabrizio Dal Moro, Chiara Zuiani, Rossano Girometti
Institute of Radiology, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy., Urology Unit, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy - ., Department of Medicine, University of Udine, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy., Pathology Unit, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy., Urology Unit, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy., Urologic Section, Department of Human and Pediatric Pathology "Gaetano Barresi", University of Messina, Messina, Italy., Urologic Clinic, University of Udine, Udine, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/33016030