eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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6/2019
vol. 11
 
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abstract:
Original paper

Detection of individual prostate cancer via multiparametric magnetic resonance imaging in own material – initial experience

Paweł Porzycki
1
,
Ewa Ciszkowicz
2

1.
Department of Urology, Municipal Hospital Rzeszow, Rzeszow, Poland
2.
Department of Biotechnology and Bioinformatics, Faculty of Chemistry, Rzeszow University of Technology, Rzeszow, Poland
J Contemp Brachytherapy 2019; 11, 6: 541–546
Online publish date: 2019/12/01
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Purpose
Multiparametric magnetic resonance imaging (mpMRI) is an evolving non-invasive imaging modality that increases the accurate localization of prostate cancer (PCa) at the time of MRI targeted biopsy, enhancing clinical risk assessment, and improving the ability to appropriately counsel patients regarding therapy.

Material and methods
A total of forty patients with prostate-specific antigen (PSA), mpMRI and Gleason score (based on MRI template-guided cognitive biopsy) results were analyzed in this study, with eight patients (20%) diagnosed with PCa. The mpMRI was performed to facilitate the decision to perform prostate biopsy. Spearman’s coefficient analysis was used to evaluate the relationships between characteristics. Diagnostic performance was assessed measuring the area under the curve (AUC) of the receiver operating characteristic (ROC) analysis. Diagnostic accuracy, sensitivity, and specificity were determined using the best cut-off on each ROC.

Results
Out of all the study group, 55% of patients were subjected to primary biopsy and 45% were directed to repeated TRUS-Bx with the suspicion of prostate cancer. Forty suspected lesions on MRI images were identified with 5% of PI-RADS 1, 17.5% of PI-RADS 2, 32.5% of PI-RADS 3, 27.5% of PI-RADS 4 (27.5%) and 17.5% of PI-RADS 5. The highest correlation was observed for mpMRI results and Gleason score with Spearman’s coefficient equal to 0.41 (95% CI: 0.104-0.646). ROC analysis revealed that mpMRI discriminates between directing the patients for prostate biopsy or active surveillance with AUC = 0.771 (0.117, 95% CI: 0.542-1.001).

Conclusions
Introducing pre-biopsy mpMRI into our contemporary PCa diagnosis pathway increased the diagnostic yield of transrectal biopsy by increasing the prostate cancer detection. This enabled the introduction of clinically significant prostate cancer (csPCa) treatment. mpMRI application also allowed biopsy to be avoided among patients with no csPCa.

keywords:

mpMRI, PI-RADS, biopsy, prostate cancer, brachytherapy

 
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