OBJECTIVES: To measure the performance characteristics of combined T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) suspicion scoring prior to MR-transrectal ultrasound (TRUS) fusion template transperineal (TTP) re-biopsy.
METHODS: Thirty-nine patients referred for prostate re-biopsy, with prior MRI examinations, were retrospectively included. The MR images, including T2W and DW-MRI, had been independently evaluated prospectively by two radiologists using a structured scoring system. An MR-TRUS fusion TTP re-biopsy was used for MR target and non-targeted biopsy cores. Targeting performance and correlation with disease status were evaluated on a per-patient and per-region basis.
RESULTS: The cancer yield was 41 % (16/39 patients). MR targeting accurately detected the disease in 12/16 (75 %) cancerous patients and missed the disease in 4/16 (25 %) patients, all with Gleason 3 + 3 disease. There was a significant relationship (P < 0.01) between MR suspicion score and the significance of cancer. Reader 1 had significantly higher sensitivity in the transition zone (TZ; 0.84) compared with the peripheral zone (PZ; 0.32) (P = 0.04). Inter-reader agreement was moderate for the PZ and substantial for the TZ.
CONCLUSIONS: MRI targeting is beneficial in the setting of TTP MR-TRUS fusion re-biopsy and MR suspicion score relates to prostate cancer clinical significance. A T2W and DW-MRI structured scoring system results in good inter-reader agreement in this setting.
Written by:
Lawrence EM, Tang SY, Barrett T, Koo B, Goldman DA, Warren AY, Axell RG, Doble A, Gallagher FA, Gnanapragasam VJ, Kastner C, Sala E. Are you the author?
Department of Radiology, University of Cambridge, Cambridge, UK.
Reference: Eur Radiol. 2014 Apr 18. Epub ahead of print.
doi: 10.1007/s00330-014-3159-0
PubMed Abstract
PMID: 24744197
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