Top

Published in:

01-05-2016 | Original Article

Relationship between non-suspicious MRI and insignificant prostate cancer: results from a monocentric study

Authors: Raphaële Renard-Penna, Morgan Roupret, Eva Compérat, François Rozet, Benjamin Granger, Johann Barkatz, Marc Olivier Bitker, Olivier Lucidarme, Olivier Cussenot, Pierre Mozer

Published in: World Journal of Urology | Issue 5/2016

Abstract

Objectives

To assess whether non-suspicious multiparametric magnetic-resonance imaging (mpMRI) was associated with no cancer or indolent prostate cancer (PCa) in subsequent biopsies.

Patients and methods

Retrospective analyses of a prospective database were conducted between 2009 and 2013. It included men with an abnormal digital rectal examination and/or prostate-specific antigen levels <20 ng/mL and a non-suspicious multiparametric MRI (Likert score <3). Participants underwent a systematic 12-extended-core biopsy ultrasound protocol (STD). Indolent PCa was defined as a single core with a Gleason score of 6 (3 + 3) and a cancer-core length of ≤4 mm.

Results

Seventy-eight patients with a negative MRI were included in the study; median patient age was 62 years (IQR 50–74). Median PSA level was 7.15 ng/mL, with a median PSA density of 0.15. The digital rectal examination was abnormal in eight cases. From MRI, 53 patients were Likert 2, 25 patients were Likert 1, and median prostate volume was 56.5 mL. From biopsies, no cancer was found in 92.3 % (n = 72). PCa was histologically confirmed in six patients (7.7 %): five cases were indolent (as defined above); only one patient had a cancer core of 5 mm long, with a Gleason score of 6 (3 + 3). All six patients were within the low-risk group according to the D’Amico classification.

Conclusion

Men with non-suspicious mpMRI are likely to have no or indolent PCa in subsequent biopsies.

Heidenreich A et al (2014) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 65(1):124–137CrossRefPubMed

Heidenreich A et al (2013) Early detection of prostate cancer: European Association of Urology recommendation. Eur Urol 64(3):347–354CrossRefPubMed

Mozer P et al (2015) First round of targeted biopsies using magnetic resonance imaging/ultrasonography fusion compared with conventional transrectal ultrasonography-guided biopsies for the diagnosis of localised prostate cancer. BJU Int 115(1):50–57CrossRefPubMed

Ridout AJ et al (2014) Role of magnetic resonance imaging in defining a biopsy strategy for detection of prostate cancer. Int J Urol 21(1):5–11CrossRefPubMed

Barentsz JO et al (2012) ESUR prostate MR guidelines 2012. Eur Radiol 22(4):746–757CrossRefPubMedPubMedCentral

Janssoone T et al (2011) Biopsym: a learning environment for trans-rectal ultrasound guided prostate biopsies. Stud Health Technol Inform 163:242–246PubMed

Moore CM et al (2013) Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: recommendations from an international working group. Eur Urol 64(4):544–552CrossRefPubMed

Puech P et al (2013) Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US–MR fusion guidance versus systematic biopsy—prospective multicenter study. Radiology 268(2):461–469CrossRefPubMed

Renard-Penna R et al (2013) Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: results from a prospective study. Urol Oncol 31(4):448–454CrossRefPubMed

10.

Renard-Penna R et al (2015) Prostate Imaging reporting and data system and Likert scoring system: multiparametric MR imaging validation study to screen patients for initial biopsy. Radiology 275(2):458–468CrossRefPubMed

11.

Dickinson L et al (2011) Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 59(4):477–494CrossRefPubMed

12.

Portalez D et al (2012) Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients. Eur Urol 62(6):986–996CrossRefPubMed

13.

Baumann M et al (2012) Prostate biopsy tracking with deformation estimation. Med Image Anal 16(3):562–576CrossRefPubMed

14.

Thompson JE et al (2014) Multiparametric magnetic resonance imaging guided diagnostic biopsy detects significant prostate cancer and could reduce unnecessary biopsies and over detection: a prospective study. J Urol 192(1):67–74CrossRefPubMed

15.

Haffner J et al (2011) Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU Int 108(8 Pt 2):E171–E178CrossRefPubMed

16.

Kirkham AP, Emberton M, Allen C (2006) How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 50(6):1163–1174 (discussion 1175) CrossRefPubMed

17.

Abd-Alazeez M et al (2014) The accuracy of multiparametric MRI in men with negative biopsy and elevated PSA level–can it rule out clinically significant prostate cancer? Urol Oncol 32(1):45e17–45e22CrossRef

18.

Wolters T et al (2011) A critical analysis of the tumor volume threshold for clinically insignificant prostate cancer using a data set of a randomized screening trial. J Urol 185(1):121–125CrossRefPubMed

19.

Itatani R et al (2014) Negative predictive value of multiparametric MRI for prostate cancer detection: outcome of 5-year follow-up in men with negative findings on initial MRI studies. Eur J Radiol 83(10):1740–1745CrossRefPubMed

20.

De Visschere PJ et al (2015) What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging? Eur Radiol. doi:10.1007/s00330-015-3894-x

21.

Arumainayagam N et al (2013) Multiparametric MR imaging for detection of clinically significant prostate cancer: a validation cohort study with transperineal template prostate mapping as the reference standard. Radiology 268(3):761–769CrossRefPubMed

22.

Tanimoto A et al (2007) Prostate cancer screening: the clinical value of diffusion-weighted imaging and dynamic MR imaging in combination with T2-weighted imaging. J Magn Reson Imaging 25(1):146–152CrossRefPubMed

23.

Numao N et al (2013) Usefulness of pre-biopsy multiparametric magnetic resonance imaging and clinical variables to reduce initial prostate biopsy in men with suspected clinically localized prostate cancer. J Urol 190(2):502–508CrossRefPubMed

24.

Kim JY et al (2014) Low-risk prostate cancer: the accuracy of multiparametric MR imaging for detection. Radiology 271(2):435–444CrossRefPubMed

25.

Wefer AE et al (2000) Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. J Urol 164(2):400–404CrossRefPubMed

26.

Schoots IG et al (2015) Magnetic resonance imaging in active surveillance of prostate cancer: a systematic review. Eur Urol 67(4):627–636CrossRefPubMed

27.

Cussenot O et al (2014) Secondary chemoprevention of localized prostate cancer by short-term androgen deprivation to select indolent tumors suitable for active surveillance: a prospective pilot phase II study. World J Urol 32(2):545–550CrossRefPubMed

28.

Drouin SJ et al (2012) Clinical characteristics and pathologic findings in patients eligible for active surveillance who underwent radical prostatectomy. Urol Oncol 30(4):402–407CrossRefPubMed

29.

Ilic D et al (2013) Screening for prostate cancer. Cochrane Database Syst Rev 1:CD004720PubMed

30.

Glaser AP, Novakovic K, Helfand BT (2012) The impact of prostate biopsy on urinary symptoms, erectile function, and anxiety. Curr Urol Rep 13(6):447–454CrossRefPubMed

31.

Ahmed HU et al (2009) Is it time to consider a role for MRI before prostate biopsy? Nat Rev Clin Oncol 6(4):197–206CrossRefPubMed

Title: Relationship between non-suspicious MRI and insignificant prostate cancer: results from a monocentric study
Authors: Raphaële Renard-Penna
Morgan Roupret
Eva Compérat
François Rozet
Benjamin Granger
Johann Barkatz
Marc Olivier Bitker
Olivier Lucidarme
Olivier Cussenot
Pierre Mozer
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1685-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Relationship between non-suspicious MRI and insignificant prostate cancer: results from a monocentric study

Abstract

Objectives

Patients and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2016

Clinical and therapeutic factors associated with adverse pathological outcomes in clinically node-negative patients treated with neoadjuvant cisplatin-based chemotherapy and radical cystectomy

Is there a place for virtual reality simulators in assessment of competency in percutaneous renal access?

Multiparametric MRI of the prostate at 3 T: limited value of 3D 1H-MR spectroscopy as a fourth parameter

Efficacy and safety of the first and repeated intradetrusor injections of abobotulinum toxin A 750 U for treating neurological detrusor overactivity

Pharmacological modulation of ureteric peristalsis in a chronically instrumented conscious pig model: effect of adrenergic and nitrergic modulation

Quality assessment in prostate cancer centers certified by the German Cancer Society