We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Negative predictive value for cancer in patients with 'Gray-Zone' PSA level and prior negative biopsy: Preliminary results with multiparametric 3.0 tesla MR.
- Authors
Girometti, Rossano; Bazzocchi, Massimo; Como, Giuseppe; Brondani, Giovanni; Del Pin, Matteo; Frea, Bruno; Martinez, Guillermo; Zuiani, Chiara
- Abstract
Purpose: To investigate the negative predictive value (NPV) for malignancy of 3.0 Tesla (T) MRI in patients with 'gray zone' PSA level and prior negative biopsies. Materials and Methods: We enrolled 26 patients with PSA level between 2.5 and 10 ng/mL and no cancer at previous biopsies. Examinations were performed on a 3.0T system using T2-weighted imaging, diffusion-weighted imaging, spectroscopy, and postcontrast dynamic study. A regional scheme was used to record MRI findings and to perform subsequent transrectal-ultrasonography-guided biopsy. Based on the matching between imaging and biopsy findings we estimated MRI predictive values, sensitivity, specificity and accuracy on a per-patient and per-region basis. Results: On a per patient basis, MRI had five true-positive (5/26; 19.2%), eight true-negative (8/26; 30.8%) and no false-negative cases, corresponding to a NPV and sensitivity of 100% each. Thirteen patients were assessed as false-positive cases (13/26; 50.0%) (specificity of 38.1%). Five of them (5/26; 19.2%) showed high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small-acinar proliferation (ASAP) at biopsy. T2-weighted imaging alone showed per-region NPV (96.8%). Conclusion: Because of the high NPV, MRI had the potential to avoid unnecessary biopsy in approximately one-third of 'gray-zone' patients with a negative examination. Additionally, MRI was useful to address to biopsy more than one-third of patients with cancer or high-risk lesions as HGPIN and ASAP. J. Magn. Reson. Imaging 2012;36:943-950. © 2012 Wiley Periodicals, Inc.
- Publication
Journal of Magnetic Resonance Imaging, 2012, Vol 36, Issue 4, p943
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.23703