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- Title
Qualitative and Quantitative Reporting of a Unique Biparametric MRI: Towards Biparametric MRI-Based Nomograms for Prediction of Prostate Biopsy Outcome in Men With a Clinical Suspicion of Prostate Cancer (IMPROD and MULTI-IMPROD Trials).
- Authors
Perez, Ileana Montoya; Jambor, Ivan; Kauko, Tommi; Verho, Janne; Ettala, Otto; Falagario, Ugo; Merisaari, Harri; Kiviniemi, Aida; Taimen, Pekka; Syvänen, Kari T.; Knaapila, Juha; Seppänen, Marjo; Rannikko, Antti; Riikonen, Jarno; Kallajoki, Markku; Mirtti, Tuomas; Lamminen, Tarja; Saunavaara, Jani; Pahikkala, Tapio; Boström, Peter J.
- Abstract
<bold>Background: </bold>Multiparametric MRI of the prostate has been shown to improve the risk stratification of men with an elevated prostate-specific antigen (PSA). However, long acquisition time, high cost, and inter-center/reader variability of a routine prostate multiparametric MRI limit its wider adoption.<bold>Purpose: </bold>To develop and validate nomograms based on unique rapid biparametric MRI (bpMRI) qualitative and quantitative derived variables for prediction of clinically significant cancer (SPCa).<bold>Study Type: </bold>Retrospective analyses of single (IMPROD, NCT01864135) and multiinstitution trials (MULTI-IMPROD, NCT02241122).<bold>Population: </bold>161 and 338 prospectively enrolled men who completed the IMPROD and MULTI-IMPROD trials, respectively.<bold>Field Strength/sequence: </bold>IMPROD bpMRI: 3T/1.5T, T2 -weighted imaging, three separate diffusion-weighted imaging (DWI) acquisitions: 1) b-values 0, 100, 200, 300, 500 s/mm2 ; 2) b values 0, 1500 s/mm2 ; 3) values 0, 2000 s/mm2 .<bold>Assessment: </bold>The primary endpoint of the combined trial analysis was the diagnostic accuracy of the combination of IMPROD bpMRI and clinical variables for detection of SPCa.<bold>Statistical Tests: </bold>Logistic regression models were developed using IMPROD trial data and validated using MULTI-IMPROD trial data. The model's performance was expressed as the area under the curve (AUC) values for the detection of SPCa, defined as ISUP Gleason Grade Group ≥2.<bold>Results: </bold>A model incorporating clinical variables had an AUC (95% confidence interval) of 0.83 (0.77-0.89) and 0.80 (0.75-0.85) in the development and validation cohorts, respectively. The corresponding values for a model using IMPROD bpMRI findings were 0.93 (0.89-0.97), and 0.88 (0.84-0.92), respectively. Further addition of the quantitative DWI-based score did not improve AUC values (P < 0.05).<bold>Data Conclusion: </bold>A prediction model using qualitative IMPROD bpMRI findings demonstrated high accuracy for predicting SPCa in men with an elevated PSA. Online risk calculator: http://petiv.utu.fi/multiimprod/ Level of Evidence: 1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1556-1567.
- Subjects
PROSTATE biopsy; PROSTATE cancer; FORECASTING; NOMOGRAPHY (Mathematics); PROSTATE-specific antigen; RESEARCH; BIOPSY; RESEARCH methodology; RETROSPECTIVE studies; MAGNETIC resonance imaging; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RESEARCH funding; STATISTICAL models; PROSTATE tumors
- Publication
Journal of Magnetic Resonance Imaging, 2020, Vol 51, Issue 5, p1556
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26975