Objective:To evaluate the efficacy of multiparametric magnetic resonance imaging(mp-MRI)using Prostate Imaging Reporting and Data System version 2.0(PI-RADSv2)definitions in detecting organ-confined prostate cancer.Me...Objective:To evaluate the efficacy of multiparametric magnetic resonance imaging(mp-MRI)using Prostate Imaging Reporting and Data System version 2.0(PI-RADSv2)definitions in detecting organ-confined prostate cancer.Methods:All patients who underwent radical prostatectomy between January 1,2014 and December 30,2014 were identified.All underwent mp-MRI within 180 days before surgery.Those with prior pelvic irradiation or androgen deprivation therapy were excluded.Fully embedded,whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location,Gleason score(GS)and stage.Results:There were 39 patients included,of which 35(90%)had mp-MRI done post-biopsy.A total of 93 cancer foci were identified on whole-mount pathology,of which mp-MRI detected 63(68%).Of those detected by mp-MRI,14 were PI-RADS 3(n=6 for GS 6,n=8 for GS 7,no GS≥8)and 49 were PI-RADS 4e5(nZ7 for GS 6,nZ33 for GS 7,and nZ9 for GS≥8).There were 30(32%)cancer foci missed by mp-MRI(n=15 for GS 6,n=13 for GS 7 and n=2 for GS≥8).A lesion classified as PI-RADS 4e5 predicted a higher grade cancer on pathology as compared to PI-RADS 3(for GS 7 lesions,odds ratio[OR]=3.53,95%CI:0.93e13.45,p=0.064).The mp-MRI size detection limit was 20 mm2 and 100 mm2 for 50%and 75%probability of cancer,respectively.In associating with radiological and pathologic stage,the weighted Kappa value was 0.69(p<0.0001).The sensitivity and positive predictive values for this study were 68%(95%CI:57%e77%)and 78%(95%CI:67%e86%),respectively.Conclusion:In this predominantly post-biopsy cohort,mp-MRI using PI-RADSv2 reporting has a reasonably high diagnostic accuracy in detecting clinically significant prostate cancer.展开更多
文摘Objective:To evaluate the efficacy of multiparametric magnetic resonance imaging(mp-MRI)using Prostate Imaging Reporting and Data System version 2.0(PI-RADSv2)definitions in detecting organ-confined prostate cancer.Methods:All patients who underwent radical prostatectomy between January 1,2014 and December 30,2014 were identified.All underwent mp-MRI within 180 days before surgery.Those with prior pelvic irradiation or androgen deprivation therapy were excluded.Fully embedded,whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location,Gleason score(GS)and stage.Results:There were 39 patients included,of which 35(90%)had mp-MRI done post-biopsy.A total of 93 cancer foci were identified on whole-mount pathology,of which mp-MRI detected 63(68%).Of those detected by mp-MRI,14 were PI-RADS 3(n=6 for GS 6,n=8 for GS 7,no GS≥8)and 49 were PI-RADS 4e5(nZ7 for GS 6,nZ33 for GS 7,and nZ9 for GS≥8).There were 30(32%)cancer foci missed by mp-MRI(n=15 for GS 6,n=13 for GS 7 and n=2 for GS≥8).A lesion classified as PI-RADS 4e5 predicted a higher grade cancer on pathology as compared to PI-RADS 3(for GS 7 lesions,odds ratio[OR]=3.53,95%CI:0.93e13.45,p=0.064).The mp-MRI size detection limit was 20 mm2 and 100 mm2 for 50%and 75%probability of cancer,respectively.In associating with radiological and pathologic stage,the weighted Kappa value was 0.69(p<0.0001).The sensitivity and positive predictive values for this study were 68%(95%CI:57%e77%)and 78%(95%CI:67%e86%),respectively.Conclusion:In this predominantly post-biopsy cohort,mp-MRI using PI-RADSv2 reporting has a reasonably high diagnostic accuracy in detecting clinically significant prostate cancer.
