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- Title
IMPROD biparametric MRI in men with a clinical suspicion of prostate cancer (IMPROD Trial): Sensitivity for prostate cancer detection in correlation with whole-mount prostatectomy sections and implications for focal therapy.
- Authors
Merisaari, Harri; Jambor, Ivan; Ettala, Otto; Boström, Peter J.; Montoya Perez, Ileana; Verho, Janne; Kiviniemi, Aida; Syvänen, Kari; Kähkönen, Esa; Eklund, Lauri; Pahikkala, Tapio; Vainio, Paula; Saunavaara, Jani; Aronen, Hannu J.; Taimen, Pekka
- Abstract
<bold>Background: </bold>Prostate MRI is increasingly being used in men with a clinical suspicion of prostate cancer (PCa). However, development and validation of methods for focal therapy planning are still lagging.<bold>Purpose: </bold>To evaluate the diagnostic accuracy on lesion, region-of-interest (ROI), and voxel level of IMPROD biparametric prostate MRI (bpMRI) for PCa detection in men with a clinical suspicion of PCa who subsequently underwent radical prostatectomy.<bold>Study Type: </bold>Prospective single-institution clinical trial (NCT01864135).<bold>Population: </bold>Sixty-four men who underwent radical prostatectomy after IMPROD bpMRI performed in prebiopsy settings.<bold>Field Strength/sequence: </bold>IMPROD bpMRI consisted of T2 -weighted imaging (T2 w) and three separate diffusion-weighted imaging acquisitions with an average acquisition time of 15 minutes.<bold>Assessment: </bold>The diagnostic accuracy of prospectively reported manual cancer delineations and regions increased with 3D dilation were evaluated on the voxel level (volume of 1.17 mm3 , 1 mm3 , 125 mm3 ) as well as the 36 ROI level. Only PCa lesions with a diameter ≥ 5 mm or any Gleason Grade 4 were analyzed. All data and protocols are freely available at: http://petiv.utu.fi/improd STATISTICAL TESTS: Sensitivity, specificity, accuracy.<bold>Results: </bold>In total, 99 PCa lesions were identified. Forty (40%, 40/99) had a Gleason score (GS) of >3 + 4. Twenty-eight PCa lesions (28%, 28/99) were missed by IMPROD bpMRI, three (7.5%, 3/40) with GS >3 + 4. 3D dilation of manual cancer delineations in all directions by ~10-12 mm (corresponding to the Hausdorff distance) was needed to achieve sensitivity approaching 100% on a voxel level.<bold>Data Conclusion: </bold>IMPROD bpMRI had a high sensitivity on lesion level for PCa with GS >3 + 4. Increasing 3D lesion delineations by ~10-12 mm (corresponding to the Hausdorff distance) was needed to achieve high sensitivity on the voxel level. Such information may help in planning ablation therapies.<bold>Level Of Evidence: </bold>1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1641-1650.
- Subjects
PROSTATE cancer; ABLATION techniques; SUSPICION; DIFFUSION magnetic resonance imaging; GLEASON grading system
- Publication
Journal of Magnetic Resonance Imaging, 2019, Vol 50, Issue 5, p1641
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26727