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European Radiology
Published in: European Radiology 2/2014

01-02-2014 | Urogenital

Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla

Authors: M. C. Roethke, T. H. Kuru, S. Schultze, D. Tichy, A. Kopp-Schneider, M. Fenchel, H.-P. Schlemmer, B. A. Hadaschik

Published in: European Radiology | Issue 2/2014

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Abstract

Objectives

To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy.

Methods

Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann–Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated.

Results

In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42 %) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/specificity for the following thresholds were calculated: 73 %/92 % and 85 %/67 % for PI-RADS scores of 9 and 10, respectively; 85 %/56 % and 60 %/97 % for Likert scores of 3 and 4, respectively.

Conclusions

The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score.

Key points

• The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI.
• To investigate suspicious findings, transperineal MR/TRUS fusion-guided biopsy was used.
• PI-RADS can guide biopsy locations and improve detection of clinically significant cancer.
• Biopsy procedures can be optimised, reducing unnecessary negative biopsies for patients.
• The PI-RADS scoring system may contribute to more effective prostate MRI.
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Metadata
Title
Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla
Authors
M. C. Roethke
T. H. Kuru
S. Schultze
D. Tichy
A. Kopp-Schneider
M. Fenchel
H.-P. Schlemmer
B. A. Hadaschik
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-3017-5

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