scholarly journals Can the predictive value of multiparametric MRI for prostate cancer be improved by a liquid biopsy with SelectMDx ?

2021 ◽  
Author(s):  
Mohammad Sajjad Rahnama'i ◽  
Christian Bach ◽  
Maximilian Schulze‐Hagen ◽  
Christiane K Kuhl ◽  
Thomas Alexander Vögeli
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Liquid Biopsy ◽  
Multiparametric Mri

Diagnostic accuracy of Multiparametric MRI in detection of prostate cancer compared with histopathology obtained by MRI directed TRUS guided cognitive fusion biopsy are T2WI, DWI and DCE enough for Indian scenario

2021 ◽  
Vol 20 (1) ◽  
pp. 10-12
Author(s):  
Mallinath Biradar ◽  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Prostatic Cancer ◽  
Tertiary Care ◽  
Multiparametric Mri ◽  
Care Hospital ◽  
Cognitive Fusion ◽  
Fusion Biopsy ◽  
Indian Scenario

Background: The incidence of prostatic carcinoma is increasing worldwide. With its high resolution, ability to provide excellent tissue characterization and multiplanar imaging capabilities, multi-parametric magnetic resonance imaging (mpMRI) plays a crucial role in detection, local staging and follow-up of carcinoma prostate. It also helps guide targeted biopsies in initial biopsy negative patient. Objectives: Study diagnostic accuracy of mp-MRI and primarily that of the three MR sequences T2, DWI and DCE in detection of prostatic cancer by correlating them with histopathology and thus whether it is feasible for a short MRI of 3 sequences to be used on a large scale in Indian scenario. Materials and Methods: A prospective study was done at a tertiary care hospital between April 2017 to November 2018 in which 50 patients who presented with suspicion of prostate cancer were referred to radiology department for evaluation using MRI. MRIexamination was done using 3T Siemens Magnetom Verio. Followed by this MRI directed TRUS guided cognitive fusion biopsy was done from the prostate. Samples were sent for histopathology. Results: Out of 50 cases studied, 24 cases (48%) were found to be malignant and 26 cases (52 %) were benign on histopathology. In our study, combined T2 + DWI + DCE gave sensitivity of 95.83 %, specificity of 57.69%, positive predictive value of 68.21 % and negative predictive value of 93.75%. Conclusion: Multiparametric MRI using T2, DWI and DCE has a high diagnostic accuracy for evaluation of prostatic cancer.

scholarly journals The utility of prostate MRI within active surveillance: description of the evidence

2021 ◽  
Author(s):  
Georgina Dominique ◽  
Wayne G. Brisbane ◽  
Robert E. Reiter
Keyword(s):  
Prostate Cancer ◽  
Negative Predictive Value ◽  
Active Surveillance ◽  
Predictive Value ◽  
Multiparametric Mri ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Active Monitoring ◽  
Initial Biopsy ◽  
Clinically Significant

Abstract Purpose We present an overview of the literature regarding the use of MRI in active surveillance of prostate cancer. Methods Both MEDLINE® and Cochrane Library were queried up to May 2020 for studies of men on active surveillance with MRI and later confirmatory biopsy. The terms studied were ‘prostate cancer’ as the anchor followed by two of the following: active surveillance, surveillance, active monitoring, MRI, NMR, magnetic resonance imaging,  MRI, and multiparametric MRI. Studies were excluded if pathologic reclassification (GG1 →  ≥ GG2) and PI-RADS or equivalent was not reported. Results Within active surveillance, baseline MRI is effective for identifying clinically significant prostate cancer and thus associated with fewer reclassification events. A positive initial MRI (≥ PI-RADS 3) with GG1 identified at biopsy has a positive predictive value (PPV) of 35–40% for reclassification by 3 years. MRI possessed a stronger negative predictive value, with a negative MRI (≤ PI-RADS 2) yielding a negative predictive value of up to 85% at 3 years. Surveillance MRI, obtained after initial biopsy, yielded a PPV of 11–65% and NPV of 85–95% for reclassification. Conclusion MRI is useful for initial risk stratification of prostate cancer in men on active surveillance, especially if MRI is negative when imaging is obtained during surveillance. While useful, MRI cannot replace biopsy and further research is necessary to fully integrate MRI into active surveillance.

scholarly journals Textured-Based Deep Learning in Prostate Cancer Classification with 3T Multiparametric MRI: Comparison with PI-RADS-Based Classification

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1785
Author(s):  
Yongkai Liu ◽  
Haoxin Zheng ◽  
Zhengrong Liang ◽  
Qi Miao ◽  
Wayne G. Brisbane ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Peripheral Zone ◽  
Significant Degree ◽  
Classification Performance ◽  
Multiparametric Mri ◽  
Superior Performance ◽  
Study Cohort

The current standardized scheme for interpreting MRI requires a high level of expertise and exhibits a significant degree of inter-reader and intra-reader variability. An automated prostate cancer (PCa) classification can improve the ability of MRI to assess the spectrum of PCa. The purpose of the study was to evaluate the performance of a texture-based deep learning model (Textured-DL) for differentiating between clinically significant PCa (csPCa) and non-csPCa and to compare the Textured-DL with Prostate Imaging Reporting and Data System (PI-RADS)-based classification (PI-RADS-CLA), where a threshold of PI-RADS ≥ 4, representing highly suspicious lesions for csPCa, was applied. The study cohort included 402 patients (60% (n = 239) of patients for training, 10% (n = 42) for validation, and 30% (n = 121) for testing) with 3T multiparametric MRI matched with whole-mount histopathology after radical prostatectomy. For a given suspicious prostate lesion, the volumetric patches of T2-Weighted MRI and apparent diffusion coefficient images were cropped and used as the input to Textured-DL, consisting of a 3D gray-level co-occurrence matrix extractor and a CNN. PI-RADS-CLA by an expert reader served as a baseline to compare classification performance with Textured-DL in differentiating csPCa from non-csPCa. Sensitivity and specificity comparisons were performed using Mcnemar’s test. Bootstrapping with 1000 samples was performed to estimate the 95% confidence interval (CI) for AUC. CIs of sensitivity and specificity were calculated by the Wald method. The Textured-DL model achieved an AUC of 0.85 (CI [0.79, 0.91]), which was significantly higher than the PI-RADS-CLA (AUC of 0.73 (CI [0.65, 0.80]); p < 0.05) for PCa classification, and the specificity was significantly different between Textured-DL and PI-RADS-CLA (0.70 (CI [0.59, 0.82]) vs. 0.47 (CI [0.35, 0.59]); p < 0.05). In sub-analyses, Textured-DL demonstrated significantly higher specificities in the peripheral zone (PZ) and solitary tumor lesions compared to the PI-RADS-CLA (0.78 (CI [0.66, 0.90]) vs. 0.42 (CI [0.28, 0.57]); 0.75 (CI [0.54, 0.96]) vs. 0.38 [0.14, 0.61]; all p values < 0.05). Moreover, Textured-DL demonstrated a high negative predictive value of 92% while maintaining a high positive predictive value of 58% among the lesions with a PI-RADS score of 3. In conclusion, the Textured-DL model was superior to the PI-RADS-CLA in the classification of PCa. In addition, Textured-DL demonstrated superior performance in the specificities for the peripheral zone and solitary tumors compared with PI-RADS-based risk assessment.

scholarly journals DIAGNOSTIC ACCURACY OF 68Ga-PSMA PET/MRI AND MULTIPARAMETRIC MRI IN DETECTING INDEX TUMOR IN RADICAL PROSTATECTOMY SPECIMEN

2021 ◽  
Author(s):  
UGUR COSAR ◽  
Ilker Sen ◽  
Uguray Aydos ◽  
Murat Yavuz Koparal ◽  
Murat Ucar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Multiparametric Mri ◽  
Psma Pet ◽  
Significant Difference ◽  
Index Tumour

ABSTRACT Objective To evaluate the diagnostic accuracy of the 68Gallium (68Ga) - prostate specific membrane antigen (PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) and multiparametric MRI (mpMRI) by region-based comparison of index tumour localisations using histopathological tumour maps of patients who underwent radical prostatectomy due to clinically significant prostate cancer. Patients and Methods The study included 64 patients who underwent radical prostatectomy after primary staging with mpMRI and 68Ga-PSMA PET/MRI. Diagnostic analysis was performed by dividing the prostate into four anatomic regions as left/right anterior and left/right posterior. The extension of the lesions in mpMRI and the pathological uptake in 68Ga-PSMA PET/MRI were matched separately for each region with the extension of the index tumour into each region. Results The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and the accuracy of mpMRI and 68Ga-PSMA PET/MRI are shown as 55.7%, 91.8%, 80.6%, 77.2%, 78.1% and 60.8%, 94.3%, 86.8% 79.8%, 83.5%, respectively. 68Ga-PSMA PET/MRI has higher sensitivity and specificity compared with mpMRI. However, no statistically significant difference was found (p = 0.464). Combined imaging had significantly higher diagnostic accuracy compared with mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.084 and 0.046, p < 0.001 and p = 0.028, respectively), while no statistically significant difference was found between mpMRI and 68Ga-PSMA PET/MRI (change in AUC: 0.038, p = 0.246). Conclusion 68Ga-PSMA PET/MRI had higher clinical diagnostic accuracy in prostate cancer compared with mpMRI. Diagnostic accuracy was significantly increased in the combined use of both imaging modalities.

scholarly journals MP03-10 CONTEMPORARY ASSESSMENT OF THE PREDICTIVE VALUE OF MULTIPARAMETRIC MRI FOR INDEX LESION LOCALIZATION IN PROSTATE CANCER

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Samuel Lagabrielle ◽  
Edouard Descat ◽  
Yann Lebras ◽  
Camille Dupin ◽  
Rémi Kaboré ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Multiparametric Mri ◽  
Index Lesion ◽  
Lesion Localization

scholarly journals Comparison of biparametric and multiparametric MRI in the diagnosis of prostate cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lili Xu ◽  
Gumuyang Zhang ◽  
Bing Shi ◽  
Yanhan Liu ◽  
Tingting Zou ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Multiparametric Mri ◽  
Dce Mri ◽  
Prostate Imaging ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Purpose To compare the diagnostic accuracy of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) and to explore the application value of dynamic contrast-enhanced (DCE) MRI in prostate imaging. Methods and materials This study retrospectively enrolled 235 patients with suspected PCa in our hospital from January 2016 to December 2017, and all lesions were histopathologically confirmed. The lesions were scored according to the Prostate Imaging Reporting and Data System version 2 (PI-RADS V2). The bpMRI (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC]) and mpMRI (T2WI, DWI/ADC and DCE) scores were recorded to plot the receiver operating characteristic (ROC) curves. The area under the curve (AUC), accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for each method were calculated and compared. The patients were further stratified according to bpMRI scores (bpMRI ≥3, and bpMRI = 3, 4, 5) to analyse the difference in DCE MRI between PCa and non-PCa lesions (as well as between csPCa and non-csPCa). Results The AUC values for the bpMRI and mpMRI protocols for PCa were comparable (0.790 [0.732–0.840] and 0.791 [0.733–0.841], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for PCa were 76.2, 79.5, 72.6, 75.8, and 76.6%, respectively, and the values for mpMRI were 77.4, 84.4, 69.9, 75.2, and 80.6%, respectively. The AUC values for the bpMRI and mpMRI protocols for the diagnosis of csPCa were similar (0.781 [0.722–0.832] and 0.779 [0.721–0.831], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for csPCa were 74.0, 83.8, 66.9, 64.8, and 85.0%, respectively; and 73.6, 87.9, 63.2, 63.2, and 87.8%, respectively, for mpMRI. For patients with bpMRI scores ≥3, positive DCE results were more common in PCa and csPCa lesions (both P = 0.001). Further stratification analysis showed that for patients with a bpMRI score = 4, PCa and csPCa lesions were more likely to have positive DCE results (P = 0.003 and P < 0.001, respectively). Conclusion The diagnostic accuracy of bpMRI is comparable with that of mpMRI in the detection of PCa and the identification of csPCa. DCE MRI is helpful in further identifying PCa and csPCa lesions in patients with bpMRI ≥3, especially bpMRI = 4, which may be conducive to achieving a more accurate PCa risk stratification. Rather than omitting DCE, we think further comprehensive studies are required for prostate MRI.

scholarly journals Differences in negative predictive value of prostate MRI based in men with suspected or known cancer

2019 ◽  
Vol 52 (5) ◽  
pp. 281-286 ◽  
Author(s):  
Armonde A. Baghdanian ◽  
Yoon-Jin Kim ◽  
Arthur H. Baghdanian ◽  
Hao N. Nguyen ◽  
Katsuto Shinohara ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Retrospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Statistical Significance ◽  
Multiparametric Mri ◽  
High Grade ◽  
Chi Square ◽  
Psa Density ◽  
Logistic Regressions

Abstract Objective: To compare the negative predictive value (NPV) of multiparametric MRI for Gleason score (GS) ≥ 3+4 cancer and evaluate predictors of these tumors in men with suspected disease and under active surveillance (AS). Materials and Methods: This retrospective study included 38 men with suspected prostate cancer and 38 under AS with scans assigned PI-RADS v2 scores 1 or 2 between May 2016 and September 2017. Biopsy results were no cancer, GS = 3+3, or GS ≥ 3+4. Pre-MRI PSA, gland volume, and PSA density were recorded. Chi-square, equality of proportions, and logistic regressions were used to analyze the data. Results: Intermediate to high-grade cancer was found in 12.8% (95% CI = 2.3-23.3) and 35.9% (95% CI = 20.8-50.9) of men with suspected cancer, and under AS (p = 0.02), respectively. The NPV for GS ≥ 3+4 were 87.2% (suspected cancer; 76.7-97.7) and 64.1% (AS; 49.0-79.2). In neither group PSA significantly predicted cancer grade (p = 0.75 and 0.63). Although it did not reach conventional statistical significance, PSA density was a good predictor of cancer grade in men with suspected disease (p = 0.06), but not under AS (p = 0.62). Conclusion: The NPV of multiparametric MRI for GS ≥ 3+4 is higher in men with suspected prostate cancer than in men under AS. PSA density ≤ 0.15 improved the prediction of intermediate to high-grade disease in patients without known cancer.

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