Top

Published in:

01-12-2010 | Urogenital

Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

Authors: Daniel Portalez, Gautier Rollin, Pierre Leandri, Benjamin Elman, Patrick Mouly, Frédéric Jonca, Bernard Malavaud

Published in: European Radiology | Issue 12/2010

Abstract

Objectives

To compare T2-weighted MRI and functional MRI techniques in guiding repeat prostate biopsies.

Methods

Sixty-eight patients with a history of negative biopsies, negative digital rectal examination and elevated PSA were imaged before repeat biopsies. Dichotomous criteria were used with visual validation of T2-weighted MRI, dynamic contrast-enhanced MRI and literature-derived cut-offs for 3D-spectroscopy MRI (choline-creatine-to-citrate ratio >0.86) and diffusion-weighted imaging (ADC × 10³ mm²/s < 1.24). For each segment and MRI technique, results were rendered as being suspicious/non-suspicious for malignancy. Sextant biopsies, transition zone biopsies and at least two additional biopsies of suspicious areas were taken.

Results

In the peripheral zones, 105/408 segments and in the transition zones 19/136 segments were suspicious according to at least one MRI technique. A total of 28/68 (41.2%) patients were found to have cancer. Diffusion-weighted imaging exhibited the highest positive predictive value (0.52) compared with T2-weighted MRI (0.29), dynamic contrast-enhanced MRI (0.33) and 3D-spectroscopy MRI (0.25). Logistic regression showed the probability of cancer in a segment increasing 12-fold when T2-weighted and diffusion-weighted imaging MRI were both suspicious (63.4%) compared with both being non-suspicious (5.2%).

Conclusion

The proposed system of analysis and reporting could prove clinically relevant in the decision whether to repeat targeted biopsies.

Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics, 2009. CA Cancer J Clin 59:225–249CrossRefPubMed

Schroder FH, Hugosson J, Roobol MJ et al (2009) Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 360:1320–1328CrossRefPubMed

Andriole GL, Crawford ED, Grubb RL 3rd et al (2009) Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 360:1310–1319CrossRefPubMed

Heidenreich A, Aus G, Bolla M et al (2008) EAU guidelines on prostate cancer. Eur Urol 53:68–80CrossRefPubMed

Sclaverano S, Chevreau G, Vadcard L, Mozer P, Troccaz J (2009) BiopSym: a simulator for enhanced learning of ultrasound-guided prostate biopsy. Stud Health Technol Inform 142:301–306PubMed

Levine MA, Ittman M, Melamed J, Lepor H (1998) Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 159:471–475, discussion 475–476CrossRefPubMed

Djavan B, Waldert M, Zlotta A et al (2001) Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol 166:856–860CrossRefPubMed

Hricak H, Choyke PL, Eberhardt SC, Leibel SA, Scardino PT (2007) Imaging prostate cancer: a multidisciplinary perspective. Radiology 243:28–53CrossRefPubMed

Reinsberg SA, Payne GS, Riches SF et al (2007) Combined use of diffusion-weighted MRI and 1H MR spectroscopy to increase accuracy in prostate cancer detection. AJR Am J Roentgenol 188:91–98CrossRefPubMed

10.

Bammer R, Auer M, Keeling SL et al (2002) Diffusion tensor imaging using single-shot SENSE-EPI. Magn Reson Med 48:128–136CrossRefPubMed

11.

Futterer JJ, Heijmink SW, Scheenen TW et al (2006) Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. Radiology 241:449–458CrossRefPubMed

12.

Engelbrecht MR, Huisman HJ, Laheij RJ et al (2003) Discrimination of prostate cancer from normal peripheral zone and central gland tissue by using dynamic contrast-enhanced MR imaging. Radiology 229:248–254CrossRefPubMed

13.

Akin O, Sala E, Moskowitz CS et al (2006) Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. Radiology 239:784–792CrossRefPubMed

14.

Jung JA, Coakley FV, Vigneron DB et al (2004) Prostate depiction at endorectal MR spectroscopic imaging: investigation of a standardized evaluation system. Radiology 233:701–708CrossRefPubMed

15.

Westphalen AC, Coakley FV, Qayyum A et al (2008) Peripheral zone prostate cancer: accuracy of different interpretative approaches with MR and MR spectroscopic imaging. Radiology 246:177–184CrossRefPubMed

16.

Zakian KL, Eberhardt S, Hricak H et al (2003) Transition zone prostate cancer: metabolic characteristics at 1H MR spectroscopic imaging–initial results. Radiology 229:241–247CrossRefPubMed

17.

Choi YJ, Kim JK, Kim N, Kim KW, Choi EK, Cho KS (2007) Functional MR imaging of prostate cancer. Radiographics 27:63–75, discussion 75–77CrossRefPubMed

18.

Remzi M, Fong YK, Dobrovits M et al (2005) The Vienna nomogram: validation of a novel biopsy strategy defining the optimal number of cores based on patient age and total prostate volume. J Urol 174:1256–1260, discussion 1260–1261; author reply 1261CrossRefPubMed

19.

Vollmer RT (1996) Multivariate statistical analysis for pathologist. Part I, the logistic model. Am J Clin Pathol 105:115–126PubMed

20.

Park BK, Lee HM, Kim CK, Choi HY, Park JW (2008) Lesion localization in patients with a previous negative transrectal ultrasound biopsy and persistently elevated prostate specific antigen level using diffusion-weighted imaging at three Tesla before rebiopsy. Invest Radiol 43:789–793CrossRefPubMed

21.

Weinreb JC, Blume JD, Coakley FV et al (2009) Prostate cancer: sextant localization at MR imaging and MR spectroscopic imaging before prostatectomy–results of ACRIN prospective multi-institutional clinicopathologic study. Radiology 251:122–133CrossRefPubMed

22.

Prando A, Kurhanewicz J, Borges AP, Oliveira EM Jr, Figueiredo E (2005) Prostatic biopsy directed with endorectal MR spectroscopic imaging findings in patients with elevated prostate specific antigen levels and prior negative biopsy findings: early experience. Radiology 236:903–910CrossRefPubMed

23.

Kelloff GJ, Choyke P, Coffey DS (2009) Challenges in clinical prostate cancer: role of imaging. AJR Am J Roentgenol 192:1455–1470CrossRefPubMed

24.

Lim HK, Kim JK, Kim KA, Cho KS (2009) Prostate cancer: apparent diffusion coefficient map with T2-weighted images for detection–a multireader study. Radiology 250:145–151CrossRefPubMed

25.

Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed

26.

Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505PubMed

27.

Turkbey B, Albert PS, Kurdziel K, Choyke PL (2009) Imaging localized prostate cancer: current approaches and new developments. AJR Am J Roentgenol 192:1471–1480CrossRefPubMed

28.

Kitajima K, Kaji Y, Kuroda K, Sugimura K (2008) High b-value diffusion-weighted imaging in normal and malignant peripheral zone tissue of the prostate: effect of signal-to-noise ratio. Magn Reson Med Sci 7:93–99CrossRefPubMed

29.

Haider MA, van der Kwast TH, Tanguay J et al (2007) Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. AJR Am J Roentgenol 189:323–328CrossRefPubMed

30.

Langer DL, van der Kwast TH, Evans AJ, Trachtenberg J, Wilson BC, Haider MA (2009) Prostate cancer detection with multi-parametric MRI: logistic regression analysis of quantitative T2, diffusion-weighted imaging, and dynamic contrast-enhanced MRI. J Magn Reson Imaging 30:327–334CrossRefPubMed

31.

Mazaheri Y, Shukla-Dave A, Hricak H et al (2008) Prostate cancer: identification with combined diffusion-weighted MR imaging and 3D 1H MR spectroscopic imaging–correlation with pathologic findings. Radiology 246:480–488CrossRefPubMed

32.

Mulkern RV, Barnes AS, Haker SJ et al (2006) Biexponential characterization of prostate tissue water diffusion decay curves over an extended b-factor range. Magn Reson Imaging 24:563–568CrossRefPubMed

33.

Riches SF, Hawtin K, Charles-Edwards EM, de Souza NM (2009) Diffusion-weighted imaging of the prostate and rectal wall: comparison of biexponential and monoexponential modelled diffusion and associated perfusion coefficients. NMR Biomed 22:318–325CrossRefPubMed

34.

Shinmoto H, Oshio K, Tanimoto A et al (2009) Biexponential apparent diffusion coefficients in prostate cancer. Magn Reson Imaging 27:355–359CrossRefPubMed

35.

Rouviere O, Raudrant A, Ecochard R et al (2003) Characterization of time-enhancement curves of benign and malignant prostate tissue at dynamic MR imaging. Eur Radiol 13:931–942PubMed

36.

Cheikh AB, Girouin N, Colombel M et al (2009) Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy. Eur Radiol 19:770–778CrossRefPubMed

37.

van Dorsten FA, van der Graaf M, Engelbrecht MR et al (2004) Combined quantitative dynamic contrast-enhanced MR imaging and (1)H MR spectroscopic imaging of human prostate cancer. J Magn Reson Imaging 20:279–287CrossRefPubMed

38.

Preziosi P, Orlacchio A, Di Giambattista G et al (2003) Enhancement patterns of prostate cancer in dynamic MRI. Eur Radiol 13:925–930PubMed

Title: Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies
Authors: Daniel Portalez
Gautier Rollin
Pierre Leandri
Benjamin Elman
Patrick Mouly
Frédéric Jonca
Bernard Malavaud
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 12/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1868-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2010

Influence of statin treatment on coronary atherosclerosis visualised using multidetector computed tomography

Effect of CT scan protocols on x-ray-induced DNA double-strand breaks in blood lymphocytes of patients undergoing coronary CT angiography

Early response assessment in patients with multiple myeloma during anti-angiogenic therapy using arterial spin labelling: first clinical results

ESUR guidelines: ovarian cancer staging and follow-up

Dynamic contrast-enhanced CT in patients treated with sorafenib and erlotinib for non-small cell lung cancer: a new method of monitoring treatment?

Pulmonary ventilation and perfusion imaging with dual-energy CT