Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology?
Abstract Objective To determine whether multiparametric magnetic resonance imaging (mp-MRI) has a role in reducing the uncertainty in risk stratification by transrectal ultrasound (TRUS) biopsy, using histology at transperineal template-guided prostate mapping (TPM) biopsy as the reference test. Mat...
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| Veröffentlicht in: | Urologic oncology 2014-08, Vol.32 (6), p.741-747 |
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| creator | Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S Ahmed, Hashim U., F.R.C.S. (UROL) Arya, Manit Allen, Clare, F.R.C.R Dikaios, Nikolaos, Ph.D Freeman, Alex, F.R.C.Path Emberton, Mark, M.D., F.R.C.S. (UROL) Kirkham, Alex, M.D., F.R.C.R |
| description | Abstract Objective To determine whether multiparametric magnetic resonance imaging (mp-MRI) has a role in reducing the uncertainty in risk stratification by transrectal ultrasound (TRUS) biopsy, using histology at transperineal template-guided prostate mapping (TPM) biopsy as the reference test. Materials and methods Overall, 194 patients underwent TRUS biopsy, who were followed up in less than 18 months by means of (a) mp-MRI with pelvic phased array using T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences and (b) TPM biopsy. Of those patients, low risk on TRUS biopsy was defined in 4 different ways—(a) definition 1: Gleason 3+3 (any cancer core length) ( n = 137), (b) definition 2: maximum cancer core length (MCCL) |
| doi_str_mv | 10.1016/j.urolonc.2014.01.008 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1551332215</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1078143914000131</els_id><sourcerecordid>1551332215</sourcerecordid><originalsourceid>FETCH-LOGICAL-e336t-96ae27c4e5ec8946f7a82a81bdc03879b5d1a775c29ec14d2ded0df50116595d3</originalsourceid><addsrcrecordid>eNo1kUFv1DAQhS1ERUvhJ4B85JLgsePEuYDQqgWkShwKZ8trTxYviR1sp9L-gv5tvGo5efTm05PfPELeAWuBQf_x2G4pzjHYljPoWgYtY-oFuQI1iIZ3Y_-yzmxQDXRivCSvcz6yCiqAV-Sy7hWMo7gijzsT6LLNxa8mmQVL8pYu5hCw1CFhjsEEi9RXzYcDXRM6bwvd1kMy7qzEiZZkQk5oi5lptUomxy04uvdxzaezSRUzNYUuMSF1OPngi39A-tvnUkMcTp_fkIvJzBnfPr_X5Nftzc_dt-bux9fvuy93DQrRl2bsDfLBdijRqrHrp8EobhTsnWVCDeNeOjDDIC0f0ULnuEPH3CQZQC9H6cQ1-fDku6b4d8Nc9OKzxXk2AeOWNUgJQnAOsqLvn9Ftv6DTa6pHSCf9_3gV-PQEYP3wg8ek7VyTWTP_wRPmY9xSqFk06Mw10_fnOs5tQMdqFQLEPxo8jIE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1551332215</pqid></control><display><type>article</type><title>Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S ; Ahmed, Hashim U., F.R.C.S. (UROL) ; Arya, Manit ; Allen, Clare, F.R.C.R ; Dikaios, Nikolaos, Ph.D ; Freeman, Alex, F.R.C.Path ; Emberton, Mark, M.D., F.R.C.S. (UROL) ; Kirkham, Alex, M.D., F.R.C.R</creator><creatorcontrib>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S ; Ahmed, Hashim U., F.R.C.S. (UROL) ; Arya, Manit ; Allen, Clare, F.R.C.R ; Dikaios, Nikolaos, Ph.D ; Freeman, Alex, F.R.C.Path ; Emberton, Mark, M.D., F.R.C.S. (UROL) ; Kirkham, Alex, M.D., F.R.C.R</creatorcontrib><description>Abstract Objective To determine whether multiparametric magnetic resonance imaging (mp-MRI) has a role in reducing the uncertainty in risk stratification by transrectal ultrasound (TRUS) biopsy, using histology at transperineal template-guided prostate mapping (TPM) biopsy as the reference test. Materials and methods Overall, 194 patients underwent TRUS biopsy, who were followed up in less than 18 months by means of (a) mp-MRI with pelvic phased array using T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences and (b) TPM biopsy. Of those patients, low risk on TRUS biopsy was defined in 4 different ways—(a) definition 1: Gleason 3+3 (any cancer core length) ( n = 137), (b) definition 2: maximum cancer core length (MCCL)<50% (any Gleason score) ( n = 62), (c) definition 3: Gleason 3+3 and MCCL<50% ( n = 52), and (d) definition 4: Gleason 3+3, MCCL<50%, prostate-specific antigen level<10 ng/ml, and<50% positive cores ( n = 28). Mp-MRI was scored for the likelihood of cancer from 1 (cancer very unlikely) to 5 (cancer very likely). Binary logistic regression analysis was performed to evaluate the association between MRI scores and TPM histology. Results Median prostate-specific antigen level was 7 ng/ml (range: 0.9–29), median time between TRUS biopsy and mp-MRI was 120 days (range: 41–480), and median time between mp-MRI and TPM biopsy was 60 days (range: 1–420). A median of 48 cores (range: 20–118) were taken at TPM biopsy. Gleason score was upgraded in 62 of 137 (45%) patients at TPM biopsy. The negative predictive values of mp-MRI score 1 to 2 for predicting that cancer remained low risk (according to each definition) were 75%, 100%, 83%, and 100% for definitions 1, 2, 3, and 4, respectively. An mp-MRI score of 4 to 5 had positive predictive values for upgrade or upsize of 59%, 67%, 75%, and 69% for definitions 1, 2, 3, and 4, respectively. Conclusion The presence of an mp-MRI lesion in men with low-risk prostate cancer on TRUS biopsy confers, in most patients, a high likelihood that higher-risk disease will be present (either Gleason pattern 4 or a significant cancer burden). Conversely, if a lesion is not seen on mp-MRI, the attribution of low-risk grade or cancer burden is much more likely to be correct. Mp-MRI might therefore be used to triage men for resampling biopsies before entering active surveillance.</description><identifier>ISSN: 1078-1439</identifier><identifier>EISSN: 1873-2496</identifier><identifier>DOI: 10.1016/j.urolonc.2014.01.008</identifier><identifier>PMID: 24981993</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Humans ; Image-Guided Biopsy - methods ; Logistic Models ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Neoplasm Grading ; Prognosis ; Prostate - pathology ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - pathology ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography, Interventional - methods ; Urology</subject><ispartof>Urologic oncology, 2014-08, Vol.32 (6), p.741-747</ispartof><rights>Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24981993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S</creatorcontrib><creatorcontrib>Ahmed, Hashim U., F.R.C.S. (UROL)</creatorcontrib><creatorcontrib>Arya, Manit</creatorcontrib><creatorcontrib>Allen, Clare, F.R.C.R</creatorcontrib><creatorcontrib>Dikaios, Nikolaos, Ph.D</creatorcontrib><creatorcontrib>Freeman, Alex, F.R.C.Path</creatorcontrib><creatorcontrib>Emberton, Mark, M.D., F.R.C.S. (UROL)</creatorcontrib><creatorcontrib>Kirkham, Alex, M.D., F.R.C.R</creatorcontrib><title>Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology?</title><title>Urologic oncology</title><addtitle>Urol Oncol</addtitle><description>Abstract Objective To determine whether multiparametric magnetic resonance imaging (mp-MRI) has a role in reducing the uncertainty in risk stratification by transrectal ultrasound (TRUS) biopsy, using histology at transperineal template-guided prostate mapping (TPM) biopsy as the reference test. Materials and methods Overall, 194 patients underwent TRUS biopsy, who were followed up in less than 18 months by means of (a) mp-MRI with pelvic phased array using T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences and (b) TPM biopsy. Of those patients, low risk on TRUS biopsy was defined in 4 different ways—(a) definition 1: Gleason 3+3 (any cancer core length) ( n = 137), (b) definition 2: maximum cancer core length (MCCL)<50% (any Gleason score) ( n = 62), (c) definition 3: Gleason 3+3 and MCCL<50% ( n = 52), and (d) definition 4: Gleason 3+3, MCCL<50%, prostate-specific antigen level<10 ng/ml, and<50% positive cores ( n = 28). Mp-MRI was scored for the likelihood of cancer from 1 (cancer very unlikely) to 5 (cancer very likely). Binary logistic regression analysis was performed to evaluate the association between MRI scores and TPM histology. Results Median prostate-specific antigen level was 7 ng/ml (range: 0.9–29), median time between TRUS biopsy and mp-MRI was 120 days (range: 41–480), and median time between mp-MRI and TPM biopsy was 60 days (range: 1–420). A median of 48 cores (range: 20–118) were taken at TPM biopsy. Gleason score was upgraded in 62 of 137 (45%) patients at TPM biopsy. The negative predictive values of mp-MRI score 1 to 2 for predicting that cancer remained low risk (according to each definition) were 75%, 100%, 83%, and 100% for definitions 1, 2, 3, and 4, respectively. An mp-MRI score of 4 to 5 had positive predictive values for upgrade or upsize of 59%, 67%, 75%, and 69% for definitions 1, 2, 3, and 4, respectively. Conclusion The presence of an mp-MRI lesion in men with low-risk prostate cancer on TRUS biopsy confers, in most patients, a high likelihood that higher-risk disease will be present (either Gleason pattern 4 or a significant cancer burden). Conversely, if a lesion is not seen on mp-MRI, the attribution of low-risk grade or cancer burden is much more likely to be correct. Mp-MRI might therefore be used to triage men for resampling biopsies before entering active surveillance.</description><subject>Aged</subject><subject>Humans</subject><subject>Image-Guided Biopsy - methods</subject><subject>Logistic Models</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Prognosis</subject><subject>Prostate - pathology</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonography, Interventional - methods</subject><subject>Urology</subject><issn>1078-1439</issn><issn>1873-2496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kUFv1DAQhS1ERUvhJ4B85JLgsePEuYDQqgWkShwKZ8trTxYviR1sp9L-gv5tvGo5efTm05PfPELeAWuBQf_x2G4pzjHYljPoWgYtY-oFuQI1iIZ3Y_-yzmxQDXRivCSvcz6yCiqAV-Sy7hWMo7gijzsT6LLNxa8mmQVL8pYu5hCw1CFhjsEEi9RXzYcDXRM6bwvd1kMy7qzEiZZkQk5oi5lptUomxy04uvdxzaezSRUzNYUuMSF1OPngi39A-tvnUkMcTp_fkIvJzBnfPr_X5Nftzc_dt-bux9fvuy93DQrRl2bsDfLBdijRqrHrp8EobhTsnWVCDeNeOjDDIC0f0ULnuEPH3CQZQC9H6cQ1-fDku6b4d8Nc9OKzxXk2AeOWNUgJQnAOsqLvn9Ftv6DTa6pHSCf9_3gV-PQEYP3wg8ek7VyTWTP_wRPmY9xSqFk06Mw10_fnOs5tQMdqFQLEPxo8jIE</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S</creator><creator>Ahmed, Hashim U., F.R.C.S. (UROL)</creator><creator>Arya, Manit</creator><creator>Allen, Clare, F.R.C.R</creator><creator>Dikaios, Nikolaos, Ph.D</creator><creator>Freeman, Alex, F.R.C.Path</creator><creator>Emberton, Mark, M.D., F.R.C.S. (UROL)</creator><creator>Kirkham, Alex, M.D., F.R.C.R</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology?</title><author>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S ; Ahmed, Hashim U., F.R.C.S. (UROL) ; Arya, Manit ; Allen, Clare, F.R.C.R ; Dikaios, Nikolaos, Ph.D ; Freeman, Alex, F.R.C.Path ; Emberton, Mark, M.D., F.R.C.S. (UROL) ; Kirkham, Alex, M.D., F.R.C.R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e336t-96ae27c4e5ec8946f7a82a81bdc03879b5d1a775c29ec14d2ded0df50116595d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Humans</topic><topic>Image-Guided Biopsy - methods</topic><topic>Logistic Models</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Prognosis</topic><topic>Prostate - pathology</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonography, Interventional - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S</creatorcontrib><creatorcontrib>Ahmed, Hashim U., F.R.C.S. (UROL)</creatorcontrib><creatorcontrib>Arya, Manit</creatorcontrib><creatorcontrib>Allen, Clare, F.R.C.R</creatorcontrib><creatorcontrib>Dikaios, Nikolaos, Ph.D</creatorcontrib><creatorcontrib>Freeman, Alex, F.R.C.Path</creatorcontrib><creatorcontrib>Emberton, Mark, M.D., F.R.C.S. (UROL)</creatorcontrib><creatorcontrib>Kirkham, Alex, M.D., F.R.C.R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Urologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abd-Alazeez, Mohamed, M.Sc. (UROL), M.R.C.S</au><au>Ahmed, Hashim U., F.R.C.S. (UROL)</au><au>Arya, Manit</au><au>Allen, Clare, F.R.C.R</au><au>Dikaios, Nikolaos, Ph.D</au><au>Freeman, Alex, F.R.C.Path</au><au>Emberton, Mark, M.D., F.R.C.S. (UROL)</au><au>Kirkham, Alex, M.D., F.R.C.R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology?</atitle><jtitle>Urologic oncology</jtitle><addtitle>Urol Oncol</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>32</volume><issue>6</issue><spage>741</spage><epage>747</epage><pages>741-747</pages><issn>1078-1439</issn><eissn>1873-2496</eissn><abstract>Abstract Objective To determine whether multiparametric magnetic resonance imaging (mp-MRI) has a role in reducing the uncertainty in risk stratification by transrectal ultrasound (TRUS) biopsy, using histology at transperineal template-guided prostate mapping (TPM) biopsy as the reference test. Materials and methods Overall, 194 patients underwent TRUS biopsy, who were followed up in less than 18 months by means of (a) mp-MRI with pelvic phased array using T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences and (b) TPM biopsy. Of those patients, low risk on TRUS biopsy was defined in 4 different ways—(a) definition 1: Gleason 3+3 (any cancer core length) ( n = 137), (b) definition 2: maximum cancer core length (MCCL)<50% (any Gleason score) ( n = 62), (c) definition 3: Gleason 3+3 and MCCL<50% ( n = 52), and (d) definition 4: Gleason 3+3, MCCL<50%, prostate-specific antigen level<10 ng/ml, and<50% positive cores ( n = 28). Mp-MRI was scored for the likelihood of cancer from 1 (cancer very unlikely) to 5 (cancer very likely). Binary logistic regression analysis was performed to evaluate the association between MRI scores and TPM histology. Results Median prostate-specific antigen level was 7 ng/ml (range: 0.9–29), median time between TRUS biopsy and mp-MRI was 120 days (range: 41–480), and median time between mp-MRI and TPM biopsy was 60 days (range: 1–420). A median of 48 cores (range: 20–118) were taken at TPM biopsy. Gleason score was upgraded in 62 of 137 (45%) patients at TPM biopsy. The negative predictive values of mp-MRI score 1 to 2 for predicting that cancer remained low risk (according to each definition) were 75%, 100%, 83%, and 100% for definitions 1, 2, 3, and 4, respectively. An mp-MRI score of 4 to 5 had positive predictive values for upgrade or upsize of 59%, 67%, 75%, and 69% for definitions 1, 2, 3, and 4, respectively. Conclusion The presence of an mp-MRI lesion in men with low-risk prostate cancer on TRUS biopsy confers, in most patients, a high likelihood that higher-risk disease will be present (either Gleason pattern 4 or a significant cancer burden). Conversely, if a lesion is not seen on mp-MRI, the attribution of low-risk grade or cancer burden is much more likely to be correct. Mp-MRI might therefore be used to triage men for resampling biopsies before entering active surveillance.</abstract><cop>United States</cop><pmid>24981993</pmid><doi>10.1016/j.urolonc.2014.01.008</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Humans Image-Guided Biopsy - methods Logistic Models Magnetic Resonance Imaging - methods Male Middle Aged Neoplasm Grading Prognosis Prostate - pathology Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - pathology Reproducibility of Results Sensitivity and Specificity Ultrasonography, Interventional - methods Urology |
| title | Can multiparametric magnetic resonance imaging predict upgrading of transrectal ultrasound biopsy results at more definitive histology? |
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