PURPOSE: To assess the ability of multiparametric (mp) MRI (mp-MRI) to identify, stratify, and localize biopsy-proven prostate cancer lesions in a risk-stratified patient population.
METHODS AND MATERIALS: We retrospectively analyzed 57 patients who had mp-MRI and core needle biopsy during diagnostic prostate cancer evaluation. The MRI sequences were scored for suspicion of cancer with a previously described system. Distributions of mp-MRI scores were compared across National Comprehensive Cancer Network prostate cancer risk groups. The mp-MRI-identified lesions were compared with the location of positive core needle biopsies to assess mp-MRI localization of true lesions.
RESULTS: The mp-MRI scoring system identified lesions in 84% (48/57) of the patients, including 100% (12/12) in the high-risk group. Scores assigned to lesions in patients in intermediate- and high-risk groups were statistically higher than those in the low-risk group, with a relative risk of 6.72 (95% confidence interval: 2.32-19.51, p< 0.001) of having an aggressive score assigned in high-risk patients compared with the low-risk patients. In comparing the localization data from core needle biopsy, 68% of the patients had an MRI-identified lesion in or within one adjacent sextant of the same prostate hemigland, including 85% of aggressive lesions.
CONCLUSIONS: Use of mp-MRI at the time of diagnosis can identify intraprostatic lesions and assign suspicion for high-risk disease. These data show that high-risk patients are more likely to have suspicious imaging-identified lesions that correlate to the location of biopsy-proven prostate cancer. At this time, the use of mp-MRI to define focal targets represents a complementary tool to patient evaluation for focal therapy strategies.
Written by:
Anderson ES, Margolis DJ, Mesko S, Banerjee R, Wang PC, Demanes DJ, Kupelian P, Kamrava M. Are you the author?
Department of Radiation Oncology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; Medical Scientist Training Program, University of California Los Angeles, Los Angeles, CA; Department of Radiology, University of California Los Angeles, Los Angeles, CA; School of Medicine, University of California, Irvine, CA.Jonsson Comprehensive Cancer Center, Los Angeles, CA.
Reference: Brachytherapy. 2014 May-Jun;13(3):292-8.
doi: 10.1016/j.brachy.2014.01.011
PubMed Abstract
PMID: 24709516
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