mpmri

BACKGROUND: Multiparametric MRI (mpMRI) is widely used for the diagnosis, surveillance, and staging of prostate cancer. However, it has several limitations, including higher costs, longer examination times, and the use of gadolinium-based contrast agents. This study aimed to investigate the accuracy of preoperatively assessed index tumors (ITs) using biparametric MRI (bpMRI)/transrectal ultrasound (TRUS) fusion biopsy compared with radical prostatectomy (RP) specimens. METHODS: We included 113 patients diagnosed with prostate cancer through bpMRI/TRUS fusion-guided biopsies of lesions with a Prostate Imaging Reporting and Data System (PI-RADS) category ≥ 3...

Multiparametric MRI (mpMRI), interpreted using PI-RADS, improves the initial detection of clinically significant prostate cancer (PCa). Prostate MR image quality has increasingly recognized relevance to the use of mpMRI for PCa diagnosis. Additionally, mpMRI is increasingly used in scenarios beyond initial detection, including active surveillance and assessment for local recurrence after prostatectomy, radiation therapy, or focal therapy. Acknowledging these evolving demands, specialized prostate MRI scoring systems beyond PI-RADS have emerged, to address distinct scenarios and unmet needs...

PURPOSE: Prostate cancer (PCa) is the most common malignancy in men aged 50 years and older and the second cause of cancer death among men. Accurate staging of PCa preoperatively is of high importance for treatment decisions and patient management. Conventional imaging modalities (ultrasound, computed tomography [CT], and magnetic resonance imaging) are inaccurate for the staging of PCa. Newer modality multiparametric magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen (PSMA) positron emission tomography (PET) scan show promising results for the staging of PCa...

BACKGROUND: To develop a risk model including clinical and radiological characteristics to predict false-positive The Prostate Imaging Reporting and Data System (PI-RADS) 5 lesions. METHODS: Data of 612 biopsy-naïve patients who had undergone multiparametric magnetic resonance imaging (mpMRI) before prostate biopsy were collected. Clinical variables and radiological variables on mpMRI were adopted. Lesions were divided into the training and validation cohort randomly...

INTRODUCTION: Recent guidelines suggest that biopsy may be omitted in some groups of patients with PI-RADS 3 lesions on mpMRI. In this study, we aimed to evaluate biopsy strategies involving prostate-specific antigen density (PSAd) to avoid unnecessary biopsy versus the risk of missing clinically significant prostate cancer (csPCa) in patients with PI-RADS 3 lesions. MATERIAL AND METHODS: Data of 616 consecutive patients who underwent PSAd and mpMRI before prostate biopsy between January 2017 and January 2022 at a single center were retrospectively assessed...

Primary prostatic lymphoma is an exceedingly rare entity comprising less than 0.09% of all prostatic cancers with follicular lymphoma making up only 12% as a subset. To our knowledge, primary follicular lymphoma co-existing with high grade prostatic adenocarcinoma presenting as a PI-RADS lesion 4 on mpMRI has not been previously described. We report the case of a 73-year-old male who presented with mildly elevated PSA and lower urinary tract symptoms. Prostate needle biopsy revealed low grade follicular lymphoma juxtaposed with high grade prostatic adenocarcinoma...

PURPOSE: Patients with advanced prostate cancer (PCa) often develop castration-resistant PCa (CRPC) with poor prognosis. Prognostic information obtained from multiparametric magnetic resonance imaging (mpMRI) and histopathology specimens can be effectively utilized through artificial intelligence (AI) techniques. The objective of this study is to construct an AI-based CRPC progress prediction model by integrating multimodal data. METHODS AND MATERIALS: Data from 399 patients diagnosed with PCa at three medical centers between January 2018 and January 2021 were collected retrospectively...

PURPOSE: Multiparametric MRI and the transperineal approach have become standard in the diagnostic pathway for suspected prostate cancer. Targeting of MRI lesions is performed at most centers, but the routine use of systematic cores is controversial. We aim to assess the value of obtaining systematic cores in patients undergoing cognitive fusion targeted double-freehand transperineal prostate biopsy. MATERIALS AND METHODS: Patients who underwent a cognitive fusion, freehand TPB at a single tertiary urology service (Perth, Australia) between November 2020 and November 2021 were retrospectively reviewed...

PURPOSE: To investigate the correlation between quantitative MR parameters and prognostic factors in prostate cancer (PCa). METHOD: A total of 186 patients with pathologically confirmed PCa who underwent preoperative multiparametric MRI (mpMRI), including synthetic MRI (SyMRI), were enrolled from two medical centers. The histogram metrics of SyMRI [T1, T2, proton density (PD)] and apparent diffusion coefficient (ADC) values were extracted. The Mann‒Whitney U test or Student's t test was employed to determine the association between these histogram features and the prognostically relevant factors...

BACKGROUND: Our understanding of patient experiences with prostate cancer testing for diagnosis and surveillance is limited. The aim of this study was to collaborate with patients and clinicians to understand their lived experience and unmet needs around the early detection, diagnosis and monitoring (active surveillance) of prostate cancer. METHODS: Two focus groups were held with patients (n = 20) and healthcare professionals (n = 16), to identify the main challenges in prostate cancer detection, diagnosis, and monitoring...

OBJECTIVE: Utilizing personalized risk assessment for clinically significant prostate cancer (csPCa) incorporating multiparametric magnetic resonance imaging (mpMRI) reduces biopsies and overdiagnosis. We validated both multi- and univariate risk models in biopsy-naïve men, with and without the inclusion of mpMRI data for csPCa detection. METHODS: N = 565 men underwent mpMRI-targeted prostate biopsy, and the diagnostic performance of risk calculators (RCs), mpMRI alone, and clinical measures were compared using receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA)...

BACKGROUND: Prostate cancer is the most common malignant tumor of male genitourinary system, and the gold standard for its diagnosis is prostate biopsy. Focusing on the methods and skills of prostate biopsy, we explored the learning curve and experience of a novel magnetic resonance imaging and transrectal ultrasound (mpMRI-TRUS) image fusion transperineal biopsy (TPB) technique using electromagnetic needle tracking under local anesthesia. METHODS: The clinical and pathological data of 92 patients who underwent targeted TPB from January 2023 to July 2023 in our center were prospectively collected...

PURPOSE: Patients with suspicion of clinically significant prostate cancer (csPC) on multiparametric prostate MRI (mpMRI) but negative or inconclusive MRI/US fusion-guided biopsy (FB) can be challenging in clinical practice. To assess the utility of MRI in-bore biopsy (IB) in patients with discordant imaging and histopathological findings after FB. METHODS: Consecutive patients with Prostate Imaging Reporting and Data System (PI-RADS) category 4 or 5 on mpMRI at 3T after FB without histologically confirmed csPC who underwent IB between 01/2014 and 05/2022, were retrospectively included...

OBJECTIVE: In contrast to other malignancies, histologic confirmation prior treatment in patients with a high suspicion of clinically significant prostate cancer (csPCA) is common. To analyze the impact of extracapsular extension (ECE), cT-stage defined by digital rectal examination (DRE), and PSA-density (PSA-D) on detection of csPCA in patients with at least one PI-RADS 5 lesion (hereinafter, "PI-RADS 5 patients"). MATERIALS AND METHODS: PI-RADS 5 patients who underwent MRI/Ultrasound fusion biopsy (Bx) between 2016 and 2020 were identified in our institutional database...

This study intended to evaluate the diagnostic accuracy of the prostate imaging reporting and data system (PI-RADS) and prostate-specific antigen density (PSAD) for clinically significant prostate cancer (csPCa) with PSA levels of 4-10 ng/ml. Between July 2018 and June 2022, a total of 453 patients with PSA levels of 4-10 ng/ml were retrospectively included, which were randomly assigned to the training group (323 patients) and validation group (130 patients). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with their 95% CI were calculated...

BACKGROUND: The aim of our study was to determine the effect of total core length (TCL) for prostate imaging reporting and data system (PI-RADS) 3 lesions to facilitate clinically significant prostate cancer (csPCa) detection based on the lesion diameter. MATERIALS AND METHODS: A total of 149 patients with at least 1 lesion with a PI-RADS 3 were evaluated retrospectively. The lesions with diameters of < 1 cm were categorized as small lesions and lesions of ≥ 1 cm were categorized as large lesions...

PURPOSE: To compare diagnostic accuracy in localization and detection of extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymph node involvement (LNI) between PSMA PET MRI and multiparametric MRI (mpMRI) in carcinoma prostate. METHODS: We did a prospective study of consecutive men with biopsy-proven prostate cancer who underwent radical prostatectomy between July'2020 and Dec'2021 at our institution. Patients underwent PSMA PET MRI imaging. MpMRI findings were inferred separately by another radiologist who was blinded to the PSMA PET findings...

OBJECTIVE: To explore how prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) should be used in concert to improve diagnostic capacity for clinically significant prostate cancers (CsCaP) in patients with prostate-specific antigen (PSA) between 4 and 20 ng/ml. METHODS: About 426 patients fulfilling the inclusion criteria were included in this study. Univariable and multivariable logistic analyses were performed to analyze the association between the clinical indicators and CaP/CsCaP...

INTRODUCTION: Prostate cancer (PCa) is a common and leading course of cancer-related death in men. Although there are studies on multiparametric magnetic resonance imaging (MpMRI) with good diagnostic results in detecting clinically significant prostate cancer, new methods have been investigated due to the low positive predictive values. In this context, Prostate Specific Membrane Antigen Positron Emission Tomography (PSMA PET) emerges as an alternative imaging method to MpMRI. This study aims to compare 68Ga PSMA I&T-PET/CT and MpMRI in determining tumor location...

BACKGROUND: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases. METHODS: A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa). RESULTS: In our cohort of 1397 men, 304 had a history of negative biopsies...