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Prostate multiparametric imaging

Veeru Kasivisvanathan, Antti S Rannikko, Marcelo Borghi, Valeria Panebianco, Lance A Mynderse, Markku H Vaarala, Alberto Briganti, Lars Budäus, Giles Hellawell, Richard G Hindley, Monique J Roobol, Scott Eggener, Maneesh Ghei, Arnauld Villers, Franck Bladou, Geert M Villeirs, Jaspal Virdi, Silvan Boxler, Grégoire Robert, Paras B Singh, Wulphert Venderink, Boris A Hadaschik, Alain Ruffion, Jim C Hu, Daniel Margolis, Sébastien Crouzet, Laurence Klotz, Samir S Taneja, Peter Pinto, Inderbir Gill, Clare Allen, Francesco Giganti, Alex Freeman, Stephen Morris, Shonit Punwani, Norman R Williams, Chris Brew-Graves, Jonathan Deeks, Yemisi Takwoingi, Mark Emberton, Caroline M Moore
Background Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited. Methods In a multicenter, randomized, noninferiority trial, we assigned men with a clinical suspicion of prostate cancer who had not undergone biopsy previously to undergo MRI, with or without targeted biopsy, or standard transrectal ultrasonography-guided biopsy...
March 18, 2018: New England Journal of Medicine
Joanna H Shih, Matthew D Greer, Baris Turkbey
RATIONALE AND OBJECTIVES: To point out the problems with Cohen kappa statistic and to explore alternative metrics to determine interobserver agreement on lesion detection when locations are not prespecified. MATERIALS AND METHODS: Use of kappa and two alternative methods, namely index of specific agreement (ISA) and modified kappa, for measuring interobserver agreement on the location of detected lesions are presented. These indices of agreement are illustrated by application to a retrospective multireader study in which nine readers detected and scored prostate cancer lesions in 163 consecutive patients (n = 110 cases, n = 53 controls) using the guideline of Prostate Imaging Reporting and Data System version 2 on multiparametric magnetic resonance imaging...
March 16, 2018: Academic Radiology
Virendra Kumar, Girdhar S Bora, Rajeev Kumar, Naranamangalam R Jagannathan
Prostate cancer (PCa) is one of the most prevalent cancers in men. A large number of men are detected with PCa; however, the clinical behavior ranges from low-grade indolent tumors that never develop into a clinically significant disease to aggressive, invasive tumors that may rapidly progress to metastatic disease. The challenges in clinical management of PCa are at levels of screening, diagnosis, treatment, and follow-up after treatment. Magnetic resonance imaging (MRI) methods have shown a potential role in detection, localization, staging, assessment of aggressiveness, targeting biopsies, etc...
April 2018: Progress in Nuclear Magnetic Resonance Spectroscopy
Sangeeta Taneja, Amarnath Jena, Rajesh Taneja, Aru Singh, Aashim Ahuja
OBJECTIVE: The purpose of this study is to assess whether temporal changes in68 Ga-prostate-specific membrane antigen (PSMA)-HBED-CC uptake and multiparametric MRI parameters derived using PET/MRI can aid in characterization of benign and malignant prostate lesions. MATERIALS AND METHODS: Thirty-five men with 29 malignant and six benign prostate lesions undergoing complete clinical workup including histologic analysis were enrolled for this retrospective study. All had undergone simultaneous whole-body68 Ga-PSMAHBED-CC PET/MRI...
March 12, 2018: AJR. American Journal of Roentgenology
Jennifer B Gordetsky, Benjamin Saylor, Sejong Bae, Jeffrey W Nix, Soroush Rais-Bahrami
OBJECTIVES: To assess management choices in patients who undergo magnetic resonance imaging (MRI)/ultrasound (MRI/US) fusion-guided prostate biopsy compared to patients who undergo systematic biopsy. METHODS: We compared men who underwent MRI/US fusion-guided prostate biopsy to those who underwent systematic 12-core biopsy from 2014 to 2016. Patient demographics and pathologic findings were reviewed. The highest grade group per case was considered for analysis. RESULTS: Follow-up was available on 133 patients who underwent MRI/US targeted biopsy and 215 patients who underwent systematic biopsy...
March 8, 2018: Urologic Oncology
Juan Gómez Rivas, Francesco Giganti, Mario Álvarez-Maestro, María Jose Freire, Veeru Kasivisvanathan, Luis Martinez-Piñero, Mark Emberton
CONTEXT: The indeterminate multiparametric prostate magnetic resonance image (mpMRI) lesion is one which cannot be classified as "positive" or "negative" for suspected cancer. Currently, there is no consensus on how to manage patients with indeterminate mpMRIs where areas cannot be classified as positives or negatives (Prostate Imaging Reporting and Data System [PI-RADS] 3 or Likert 3). OBJECTIVE: To define the concept of indeterminate lesion and describe the management strategies that may be adopted for these patients...
March 7, 2018: European Urology Focus
Sung Yoon Park, Nam Hoon Cho, Dae Chul Jung, Young Taik Oh
The main purpose of Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) is to effectively detect clinically significant prostate cancers (csPCa) using multiparametric magnetic resonance imaging. Since the first introduction of PI-RADSv2, researchers have validated its diagnostic performance in identifying csPCa, and these promising data have influenced biopsy and treatment schemes. However, in this article, we focused on the potential of PI-RADSv2 in relation to various aspects of PCa such as Gleason score, tumor volume, extraprostatic extension, lymph node metastasis, and postoperative biochemical recurrence, beyond prostate cancer detection...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Hüseyin Cihan Demirel, John Warren Davis
Multiparametric magnetic resonance imaging (mpMRI) has managed to change the paradigms on prostate cancer detection and risk classification. The most clear-cut indication of mpMRI in guidelines is the patients with a history of negative biopsy/increasing prostate-specific antigen (PSA), and presence of additional findings supporting its use in non biopsied patients and active surveillance. mpMRI complements standard clinical exam, PSA measurements, and systematic biopsy, and will miss some tumors that lack enough size or change in tissue density...
March 2018: Turkish Journal of Urology
Sung Il Jung, Sung Il Jung, Hae Jeong Jeon, Hee Sun Park, Mi Hye Yu, Young Jun Kim, Seung Eun Lee, So Dug Lim
OBJECTIVE: To evaluate effect of postbiopsy hemorrhage on detection of peripheral zone (PZ) prostate cancer by multiparametric MR imaging according to Gleason score and tumor volume. METHODS: This retrospective study included 54 biopsy-proven prostate cancer patients (median age, 67.0 years) who underwent multiparametric MR imaging. Two independent readers evaluated each sextant of the PZ using the PI-RADS v2. One reader recorded the presence or absence of hemorrhage per sextant on T1-weighted MR images...
March 1, 2018: British Journal of Radiology
Alison D Sheridan, Sameer K Nath, Sanjay Aneja, Jamil S Syed, Jay Pahade, Mahan Mathur, Preston Sprenkle, Jeffrey C Weinreb, Michael Spektor
OBJECTIVE: The purpose of this study was to determine imaging and clinical features associated with Prostate Imaging Reporting and Data System (PI-RADS) category 5 lesions identified prospectively at multiparametric MRI (mpMRI) that were found benign at MRI-ultrasound fusion targeted biopsy. MATERIALS AND METHODS: Between January 2015 and July 2016, 325 men underwent prostate mpMRI followed by MRI-ultrasound fusion targeted biopsy of 420 lesions prospectively identified and assessed with PI-RADS version 2...
February 28, 2018: AJR. American Journal of Roentgenology
Raj P Pal, Ros Ahmad, Shaun Trecartan, James Voss, Shaista Ahmed, Alvaro Bazo, Jon Lloyd, Thomas J Walton
OBJECTIVES: This study evaluated the diagnostic performance of Transrectal-ultrasound guided biopsy (TRUSB) and Multiparametric MRI (mpMRI) in detecting prostate cancer (CaP) against Transperineal prostate mapping biopsy (TPM) as the reference test. METHODS: Between April 2012 and January 2016 426 patients underwent TRUS biopsy, mpMRI and TPM. Patients initially underwent systematic 12 core TRUSB, followed 3 months later by mpMRI (1.5T, high resolution T2 images, DWI, DCE)...
February 22, 2018: Journal of Urology
S Tavolaro, P Mozer, M Roupret, E Comperat, F Rozet, E Barret, S Drouin, C Vaessen, O Lucidarme, O Cussenot, F Boudghène, R Renard-Penna
PURPOSE: The purpose of this study was to evaluate precise location criteria on magnetic resonance imaging (MRI) to improve detection of transition zone (TZ) and anterior stroma (AS) prostate cancers using targeted MRI/transrectal ultrasound fusion biopsies as a reference standard. MATERIAL AND METHODS: Ninety-six men (mean age: 65 years±7.7 [SD] [range: 46-83 years]) with an elevated prostate-specific antigen (PSA) (PSA≥4ng/mL) who underwent standard and targeted biopsies on a TZ/AS suspicious lesion were included...
February 21, 2018: Diagnostic and Interventional Imaging
Francesco Porpiglia, Matteo Manfredi, Fabrizio Mele, Riccardo Bertolo, Enrico Bollito, Dario Gned, Agostino De Pascale, Filippo Russo, Roberto Passera, Cristian Fiori, Stefano De Luca
BACKGROUND: The Briganti updated nomogram (BN) is the most popular predictive model aiming to predict the presence of lymph node invasion (LNI) in patients with prostate cancer (PCa), but it lacks information obtained by preoperative imaging. The primary aim of the study was to evaluate the role of multiparametric prostate magnetic resonance imaging (mp-MRI) in the indication to perform pelvic lymph nodes dissection (PLND) or not in patients with risk of LNI according to BN below 5%. METHODS: Since March 2012 and September 2016, 310 patients who underwent a preoperative mp-MRI for staging purpose and subsequent robot-assisted extended PLND (RAEPLND) were retrospectively evaluated...
February 22, 2018: Prostate Cancer and Prostatic Diseases
Sherif Mehralivand, Joanna H Shih, Soroush Rais-Bahrami, Aytekin Oto, Sandra Bednarova, Jeffrey W Nix, John V Thomas, Jennifer B Gordetsky, Sonia Gaur, Stephanie A Harmon, Mohummad Minhaj Siddiqui, Maria J Merino, Howard L Parnes, Bradford J Wood, Peter A Pinto, Peter L Choyke, Baris Turkbey
Importance: Multiparametric magnetic resonance imaging (MRI) in conjunction with MRI-transrectal ultrasound (TRUS) fusion-guided biopsies have improved the detection of prostate cancer. It is unclear whether MRI itself adds additional value to multivariable prediction models based on clinical parameters. Objective: To determine whether an MRI-based prediction model can reduce unnecessary biopsies in patients with suspected prostate cancer. Design, Setting, and Participants: Patients underwent MRI, MRI-TRUS fusion-guided biopsy, and 12-core systematic biopsy in 1 session...
February 22, 2018: JAMA Oncology
Peigang Ning, Dapeng Shi, Geoffrey A Sonn, Shreyas S Vasanawala, Andreas M Loening, Pejman Ghanouni, Piotr Obara, Lewis K Shin, Richard E Fan, Brian A Hargreaves, Bruce L Daniel
To evaluate the performance of computed high b value diffusion-weighted images (DWI) in prostate cancer detection. 97 consecutive patients who had undergone multiparametric MRI of the prostate followed by biopsy were reviewed. Five radiologists independently scored 138 lesions on native high b-value images (b = 1200 s/mm2 ), apparent diffusion coefficient (ADC) maps, and computed high b-value images (contrast equivalent to b = 2000 s/mm2 ) to compare their diagnostic accuracy. Receiver operating characteristic (ROC) analysis and McNemar's test were performed to assess the relative performance of computed high b value DWI, native high b-value DWI and ADC maps...
February 21, 2018: Scientific Reports
Kirsten Bouchelouche, Peter L Choyke
PURPOSE OF REVIEW: In recent years, a large number of reports have been published on prostate-specific membrane antigen (PSMA)/PET in prostate cancer (PCa). This review highlights advances in PSMA PET in PCa during the past year. RECENT FINDINGS: PSMA PET/computed tomography (CT) is useful in detection of biochemical recurrence, especially at low prostate-specific antigen (PSA) values. The detection rate of PSMA PET is influenced by PSA level. For primary PCa, PSMA PET/CT shows promise for tumour localization in the prostate, especially in combination with multiparametric MRI (mpMRI)...
February 19, 2018: Current Opinion in Oncology
Alexandre Fourcade, Charlotte Payrard, Valentin Tissot, Marie-Aimée Perrouin-Verbe, Nicolas Demany, Sophie Serey-Effeil, Pierre Callerot, Jean-Baptiste Coquet, Laurent Doucet, Charles Deruelle, Vincent Joulin, Michel Nonent, Georges Fournier, Antoine Valeri
OBJECTIVE: Compared with standard systematic transrectal ultrasound (TRUS)-guided biopsies (SBx), targeted biopsies (TBx) using magnetic resonance imaging (MRI)/TRUS fusion could increase the detection of clinically significant prostate cancer (PCa-s) and reduce non-significant PCa (PCa-ns). This study aimed to compare the performance of the two approaches. MATERIALS AND METHODS: A prospective, single-center study was conducted on all consecutive patients with PCa suspicion who underwent prebiopsy multiparametric MRI (mpMRI) using the Prostate Imaging Reporting and Data System (PI-RADS)...
February 20, 2018: Scandinavian Journal of Urology
Irene A Burger, Andrei Gafita, Julian Müller, Benedikt Kranzbühler, Olivio F Donati, Daniel Eberli
Restaging local recurrence after high-intensity focused ultra-sound (HIFU) is based on multiparametric MRI (mpMRI). However, postinterventional changes of the tissue, such as edema or hemorrhage, are limiting tumor detection on mpMRI. We present a case of a rising prostate-specific antigen values, negative mpMRI, and a Gleason score of 4+4 on template biopsy after HIFU. On F-choline PET/MR, high focal uptake was detected at the location of positive biopsy. Re-HIFU based on the fused F-choline PET/MR images was performed, followed by a recurrence-free period of 11 months...
April 2018: Clinical Nuclear Medicine
Andrew B Rosenkrantz, Jovan Begovic, Antonio Pires, Eugene Won, Samir S Taneja, James S Babb
PURPOSE: To assess the effect on reader performance of an interactive case-based online tutorial for prostate magnetic resonance imaging (MRI) interpretation using Prostate Imaging and Reporting Data System (PI-RADS). METHODS: An educational website was developed incorporating scrollable multiparametric prostate MRI examinations with annotated solutions based on PI-RADS version 2. Three second-year radiology residents evaluated a separate set of 60 prostate MRI examinations both before and after review of the online case material, identifying and scoring dominant lesions...
January 10, 2018: Current Problems in Diagnostic Radiology
Saradwata Sarkar, Sadhna Verma
Conventional ultrasound-guided prostate biopsies have multiple limitations leading to underdetection of clinically significant prostate cancer (PCa) and overdetection of clinically insignificant PCa. Multiparametric MR imaging of the prostate offers better localization of prostatic tumors in comparison with ultrasound imaging and can help address these limitations. MR imaging-identified lesions can be targeted for biopsy directly in-gantry or indirectly using a fusion of MR imaging and ultrasound imaging. The fusion may be performed by the operator visually or using a software fusion device...
March 2018: Radiologic Clinics of North America
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