Impact of changing PI-RADS cutoff on prostate cancer detection by MRI cognitive fusion biopsy in biopsy-naïve patients.

IF 2.1 Q3 ONCOLOGY Journal of the Egyptian National Cancer Institute Pub Date : 2023-03-06 DOI:10.1186/s43046-023-00165-4

Hesham Abdel-Azim El-Helaly, Asem Abdel-Aziz Mahmoud, Ahmed Mohamed Magdy, Abdelwahab Hasehem, Hamdy Mohamed Ibrahim, Khaled Moheyelden Mohamed, Mohamed Hamdy Ismail

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Abstract

Background: Multi-parametric magnetic resonance imaging may improve the detection of prostate cancer. The aim of this work is to compare between PI-RADS 3-5 and PI-RADS 4-5 as a threshold for targeted prostatic biopsy.

Methods: This is a prospective clinical study that included 40 biopsy-naïve patients referred for prostate biopsy. Patients underwent prebiopsy multi-parametric (mp-MRI), followed by 12-core transrectal ultrasound-guided systematic biopsy and cognitive MRI/TRUS fusion targeted biopsy from each detected lesion. The primary endpoint was to assess the diagnostic accuracy of the PI-RAD 3-4 versus PI-RADS 4-5 lesion by mpMRI for prostate cancer detection in biopsy-naive men.

Results: The overall prostate cancer detection rate and the clinically significant cancer detection rate were 42.5% and 35%, respectively. Targeted biopsies from PI-RADS 3-5 lesions showed a sensitivity of 100%, specificity of 44%, positive predictive value of 51.7%, and negative predictive value of 100%. Restricting targeted biopsies to PI-RADS 4-5 lesions resulted in a decrease in sensitivity and negative predictive value to 73.3% and 86.2%, respectively, while specificity and positive predictive value were increased to 100% for both parameters which was statistically significant (P value < 0.0001 and P value = 0.004, respectively).

Conclusions: Limiting the TBs to PI-RADS 4-5 lesions improves the performance of mp-MRI in the detection of prostate cancer especially aggressive tumors.

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改变PI-RADS切断对biopsy-naïve患者MRI认知融合活检检测前列腺癌的影响。

背景:多参数磁共振成像可以提高前列腺癌的检出率。这项工作的目的是比较PI-RADS 3-5和PI-RADS 4-5作为靶向前列腺活检的阈值。方法:这是一项前瞻性临床研究，包括40例biopsy-naïve患者转介前列腺活检。患者进行活检前多参数(mp-MRI)检查，随后对每个检测到的病变进行12核经直肠超声引导的系统活检和认知MRI/TRUS融合靶向活检。主要终点是评估PI-RADS 3-4与PI-RADS 4-5病变在未接受活检的男性前列腺癌检测中的mpMRI诊断准确性。结果:总体前列腺癌检出率为42.5%，临床显著癌检出率为35%。PI-RADS 3-5病灶的靶向活检敏感性为100%，特异性为44%，阳性预测值为51.7%，阴性预测值为100%。将靶向活检限制在PI-RADS 4-5病灶范围内，敏感性和阴性预测值分别降低至73.3%和86.2%，特异性和阳性预测值均提高至100%，差异有统计学意义(P值)。结论:将靶活检限制在PI-RADS 4-5病灶范围内，可提高mp-MRI对前列腺癌尤其是侵袭性肿瘤的检测效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Egyptian National Cancer Institute ONCOLOGY-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

11 weeks

期刊介绍： As the official publication of the National Cancer Institute, Cairo University, the Journal of the Egyptian National Cancer Institute (JENCI) is an open access peer-reviewed journal that publishes on the latest innovations in oncology and thereby, providing academics and clinicians a leading research platform. JENCI welcomes submissions pertaining to all fields of basic, applied and clinical cancer research. Main topics of interest include: local and systemic anticancer therapy (with specific interest on applied cancer research from developing countries); experimental oncology; early cancer detection; randomized trials (including negatives ones); and key emerging fields of personalized medicine, such as molecular pathology, bioinformatics, and biotechnologies.