Quantifying the Effect of Location Matching on Accuracy of Multiparametric Magnetic Resonance Imaging Prior to Prostate Biopsy—A Multicentre Study

European Urology Open Science

Raymond Kim¹  Matthew Krelle²  Samantha Koschel²  Kushlan Aluwihare³  Mark Jenkins⁴  Yuigi Yuminaga⁵  Mark Louie-Johnsun⁶  Dominic James Gavin⁶  Janelle Brennan⁷  Tom Sutherland⁷  Sarah Skinner⁷  Jonathan Kam⁷  Lih-Ming Wong⁸ 

[1] Department of Urology, St Vincent’s Hospital Melbourne, Victoria, Australia;University of Newcastle, Newcastle, Australia;Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia;Department of Radiology, St Vincent’s Hospital Melbourne, Victoria, Australia;Department of Urology, Bendigo Health, Bendigo, Victoria, Australia;Eastern Hill Academic Centre, St Vincent’s Hospital Melbourne, Victoria, Australia;Gosford District Hospital and Gosford Private Hospital, Gosford, Australia;PRP Radiology, Australia;

关键词: Diagnostic accuracy;    Multiparametric magnetic resonance imaging;    Prostate biopsy;    Prostate cancer;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Multiparametric magnetic resonance imaging (mpMRI) has shown promise to improve detection of prostate cancer over conventional methods. However, most studies do not describe whether the location of mpMRI lesions match that of cancer found at biopsy, which may lead to an overestimation of accuracy. Objective: To quantitate the effect of mapping locations of mpMRI lesions to locations of positive biopsy cores on the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of mpMRI. Design, setting, and participant: We retrospectively identified patients having mpMRI of the prostate preceding prostate biopsy at three centres from 2013 to 2016. Men with targetable lesions on imaging underwent directed biopsy in addition to systematic biopsy. We correlated locations of positive mpMRI lesions with those of positive biopsy cores, defining a match when both were in the same sector of the prostate. We defined positive mpMRI as Prostate Imaging Reporting and Data System (PI-RADS) score ≥4 and significant cancer at biopsy as grade group ≥2. Outcome measurements and statistical analysis: Sensitivity, specificity, PPV, and NPV were calculated with and without location matching. Results and limitations: Of 446 patients, 247 (55.4%) had positive mpMRI and 232 (52.0%) had significant cancer at biopsy. Sensitivity and NPV for detecting significant cancer with location matching (both 63.4%) were decreased compared with those without location matching (77.6% and 73.9%, respectively). Of the 85 significant cancers not detected by mpMRI, most were of grade group 2 (64.7%, 55/85). Conclusions: We report a 10–15% decrease in sensitivity and NPV when location matching was used to detect significant prostate cancer by mpMRI. False negative mpMRI remains an issue, highlighting the continued need for biopsy and for improving the standards around imaging quality and reporting. Patient summary: The true accuracy of multiparametric magnetic resonance imaging (mpMRI) must be determined to interpret results and better counsel patients. We mapped the location of positive mpMRI lesions to where cancer was found at biopsy and found, when compared with matching to cancer anywhere in the prostate, that the accuracy of mpMRI decreased by 10–15%.

【 授权许可】

Unknown