Utility of Multiparametric Magnetic Resonance Imaging Suspicion Levels for Detecting Prostate Cancer

被引:156
|
作者
Rais-Bahrami, Soroush [1 ]
Siddiqui, M. Minhaj [1 ]
Turkbey, Baris [2 ]
Stamatakis, Lambros [1 ]
Logan, Jennifer [1 ]
Hoang, Anthony N. [1 ]
Walton-Diaz, Annerleim [1 ]
Vourganti, Srinivas [1 ]
Truong, Hong [1 ]
Kruecker, Jochen [4 ,5 ]
Merino, Maria J. [3 ]
Wood, Bradford J. [4 ]
Choyke, Peter L. [2 ]
Pinto, Peter A. [1 ,4 ]
机构
[1] NCI, Urol Oncol Branch, Bethesda, MD 20892 USA
[2] NCI, Mol Imaging Program, Bethesda, MD 20892 USA
[3] NCI, Pathol Lab, Bethesda, MD 20892 USA
[4] Natl Canc Inst & Clin Ctr, Ctr Intervent Oncol, NIH, Bethesda, MD USA
[5] Philips Res North America, Briarcliff Manor, NY USA
来源
JOURNAL OF UROLOGY | 2013年 / 190卷 / 05期
基金
美国国家卫生研究院;
关键词
neoplasm grading; magnetic resonance imaging; digital rectal examination; prostate; biopsy; ACTIVE SURVEILLANCE; ULTRASOUND FUSION; TUMOR VOLUME; BIOPSY; SPECIMENS; MRI;
D O I
10.1016/j.juro.2013.05.052
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We determine the usefulness of multiparametric magnetic resonance imaging in detecting prostate cancer, with a specific focus on detecting higher grade prostate cancer. Materials and Methods: Prospectively 583 patients who underwent multiparametric magnetic resonance imaging and subsequent prostate biopsy at a single institution were evaluated. On multiparametric magnetic resonance imaging, lesions were identified and scored as low, moderate or high suspicion for prostate cancer based on a validated scoring system. Magnetic resonance/ultra-sound fusion guided biopsies of magnetic resonance imaging lesions in addition to systematic 12-core biopsies were performed. Correlations between the highest assigned multiparametric magnetic resonance imaging suspicion score and presence of cancer and biopsy Gleason score on the first fusion biopsy session were assessed using univariate and multivariate logistic regression models. Sensitivity, specificity, negative predictive value and positive predictive value were calculated and ROC curves were developed to assess the discriminative ability of multiparametric magnetic resonance imaging as a diagnostic tool for various biopsy Gleason score cohorts. Results: Significant correlations were found between age, prostate specific antigen, prostate volume, and multiparametric magnetic resonance imaging suspicion score and the presence of prostate cancer (p < 0.0001). On multivariate analyses controlling for age, prostate specific antigen and prostate volume, increasing multiparametric magnetic resonance imaging suspicion was an independent prognosticator of prostate cancer detection (OR 2.2, p < 0.0001). Also, incremental increases in multiparametric magnetic resonance imaging suspicion score demonstrated stronger associations with cancer detection in patients with Gleason 7 or greater (OR 3.3, p < 0.001) and Gleason 8 or greater (OR 4.2, p < 0.0001) prostate cancer. Assessing multiparametric magnetic resonance imaging as a diagnostic tool for all prostate cancer, biopsy Gleason score 7 or greater, and biopsy Gleason score 8 or greater separately via ROC analyses demonstrated increasing accuracy of multiparametric magnetic resonance imaging for higher grade disease (AUC 0.64, 0.69, and 0.72, respectively). Conclusions: Multiparametric magnetic resonance imaging is a clinically useful modality to detect and characterize prostate cancer, particularly in men with higher grade disease.
引用
收藏
页码:1721 / 1727
页数:7
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