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European Radiology
Published in: European Radiology 7/2014

01-07-2014 | Urogenital

Prostate cancer: performance characteristics of combined T2W and DW-MRI scoring in the setting of template transperineal re-biopsy using MR-TRUS fusion

Authors: Edward M. Lawrence, Sarah Y. W. Tang, Tristan Barrett, Brendan Koo, Debra A. Goldman, Anne Y. Warren, Richard G. Axell, Andrew Doble, Ferdia A. Gallagher, Vincent J. Gnanapragasam, Christof Kastner, Evis Sala

Published in: European Radiology | Issue 7/2014

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Abstract

Objectives

To measure the performance characteristics of combined T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) suspicion scoring prior to MR-transrectal ultrasound (TRUS) fusion template transperineal (TTP) re-biopsy.

Methods

Thirty-nine patients referred for prostate re-biopsy, with prior MRI examinations, were retrospectively included. The MR images, including T2W and DW-MRI, had been independently evaluated prospectively by two radiologists using a structured scoring system. An MR-TRUS fusion TTP re-biopsy was used for MR target and non-targeted biopsy cores. Targeting performance and correlation with disease status were evaluated on a per-patient and per-region basis.

Results

The cancer yield was 41 % (16/39 patients). MR targeting accurately detected the disease in 12/16 (75 %) cancerous patients and missed the disease in 4/16 (25 %) patients, all with Gleason 3 + 3 disease. There was a significant relationship (P < 0.01) between MR suspicion score and the significance of cancer. Reader 1 had significantly higher sensitivity in the transition zone (TZ; 0.84) compared with the peripheral zone (PZ; 0.32) (P = 0.04). Inter-reader agreement was moderate for the PZ and substantial for the TZ.

Conclusions

MRI targeting is beneficial in the setting of TTP MR-TRUS fusion re-biopsy and MR suspicion score relates to prostate cancer clinical significance. A T2W and DW-MRI structured scoring system results in good inter-reader agreement in this setting.

Key Points

• Pre-biopsy MRI aids the detection of high significance cancer during prostate re-biopsy.
• MRI suspicion level correlates with the clinical significance of prostate cancer detected.
• T 2 W and DW-MRI structured scoring of pre-biopsy MRI permits good inter-reader agreement.
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Metadata
Title
Prostate cancer: performance characteristics of combined T2W and DW-MRI scoring in the setting of template transperineal re-biopsy using MR-TRUS fusion
Authors
Edward M. Lawrence
Sarah Y. W. Tang
Tristan Barrett
Brendan Koo
Debra A. Goldman
Anne Y. Warren
Richard G. Axell
Andrew Doble
Ferdia A. Gallagher
Vincent J. Gnanapragasam
Christof Kastner
Evis Sala
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3159-0

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