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European Radiology

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01-02-2018 | Oncology

Prostate cancer detection among readers with different degree of experience using ultra-high b-value diffusion-weighted Imaging: Is a non-contrast protocol sufficient to detect significant cancer?

Authors: D. Hausmann, N. Aksöz, J. von Hardenberg, T. Martini, N. Westhoff, S. Buettner, S.O. Schoenberg, P. Riffel

Published in: European Radiology | Issue 2/2018

Abstract

Aim

To evaluate the accuracy of a T2-weighted (T2w) – and a parallel transmit zoomed b = 2000 s/mm2 (b2000) – diffusion-weighted imaging sequence among three readers with different degrees of experience for prostate cancer (Pca) detection.

Methods

Ninety-three patients with suspected Pca were enrolled. For b2000 a two-dimensional spatially-selective RF pulse using an echo-planar transmit trajectory was applied, and the field of view (FOV) was reduced to one-third. All three readers (Reader A: 7, B 4 and C <1 years of experience in prostate MRI) independently evaluated b2000 with regard to the presence of suspicious lesions that displayed increased signal. The results were compared to histopathology obtained by real-time MR/ultrasound fusion and systematic biopsy.

Results

In 62 patients Pca was confirmed. One significant Pca (Gleason score (GS) 7b) was missed by Reader C. Overall, sensitivity/specificity/positive predictive value/negative predictive value were 90/71/86/79% for Reader A, 87/84/92/76% for Reader B and 85/74/87/72% for Reader C, respectively. Detection rates for significant Pca (GS >7a) were 100/100/94% for Readers A/B/C, respectively. Inter-reader agreement was generally good (Kappa A/B: 0.8; A/C: 0.82; B/C: 0.74).

Conclusion

B2000 in combination with a T2w could be useful to detect clinically significant Pca.

Key Points

• Significant prostate cancer using zoomed ultra-high b-value DWI was detected.

• Diagnostic performance among readers with different degrees of experience was good.

• mp- MRI of the prostate using a comprehensive non-contrast protocol is clinically feasible.

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Title: Prostate cancer detection among readers with different degree of experience using ultra-high b-value diffusion-weighted Imaging: Is a non-contrast protocol sufficient to detect significant cancer?
Authors: D. Hausmann
N. Aksöz
J. von Hardenberg
T. Martini
N. Westhoff
S. Buettner
S.O. Schoenberg
P. Riffel
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5004-8

At a glance: The STEP trials

Springer Medicine

Prostate cancer detection among readers with different degree of experience using ultra-high b-value diffusion-weighted Imaging: Is a non-contrast protocol sufficient to detect significant cancer?

Abstract

Aim

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

Key Points

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