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- Title
Prostate cancer: performance characteristics of combined T₂W and DW-MRI scoring in the setting of template transperineal re-biopsy using MR-TRUS fusion.
- Authors
Lawrence, Edward M; Tang, Sarah Y W; Barrett, Tristan; Koo, Brendan; Goldman, Debra A; Warren, Anne Y; Axell, Richard G; Doble, Andrew; Gallagher, Ferdia A; Gnanapragasam, Vincent J; Kastner, Christof; Sala, Evis
- Abstract
<bold>Objectives: </bold>To measure the performance characteristics of combined T2-weighted (T₂W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) suspicion scoring prior to MR-transrectal ultrasound (TRUS) fusion template transperineal (TTP) re-biopsy.<bold>Methods: </bold>Thirty-nine patients referred for prostate re-biopsy, with prior MRI examinations, were retrospectively included. The MR images, including T₂W and DW-MRI, had been independently evaluated prospectively by two radiologists using a structured scoring system. An MR-TRUS fusion TTP re-biopsy was used for MR target and non-targeted biopsy cores. Targeting performance and correlation with disease status were evaluated on a per-patient and per-region basis.<bold>Results: </bold>The cancer yield was 41% (16/39 patients). MR targeting accurately detected the disease in 12/16 (75%) cancerous patients and missed the disease in 4/16 (25%) patients, all with Gleason 3 + 3 disease. There was a significant relationship (P < 0.01) between MR suspicion score and the significance of cancer. Reader 1 had significantly higher sensitivity in the transition zone (TZ; 0.84) compared with the peripheral zone (PZ; 0.32) (P = 0.04). Inter-reader agreement was moderate for the PZ and substantial for the TZ.<bold>Conclusions: </bold>MRI targeting is beneficial in the setting of TTP MR-TRUS fusion re-biopsy and MR suspicion score relates to prostate cancer clinical significance. A T₂W and DW-MRI structured scoring system results in good inter-reader agreement in this setting.<bold>Key Points: </bold>• Pre-biopsy MRI aids the detection of high significance cancer during prostate re-biopsy. • MRI suspicion level correlates with the clinical significance of prostate cancer detected. • T₂W and DW-MRI structured scoring of pre-biopsy MRI permits good inter-reader agreement.
- Publication
European Radiology, 2014, Vol 24, Issue 7, p1497
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-014-3159-0