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Prospective Evaluation of PI-RADS Version 2.1 for Prostate Cancer Detection and Investigation of Multiparametric MRI-derived Markers.
Yilmaz, Enis C; Shih, Joanna H; Belue, Mason J; Harmon, Stephanie A; Phelps, Tim E; Garcia, Charisse; Hazen, Lindsey A; Toubaji, Antoun; Merino, Maria J; Gurram, Sandeep; Choyke, Peter L; Wood, Bradford J; Pinto, Peter A; Turkbey, Baris.
Afiliação
  • Yilmaz EC; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Shih JH; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Belue MJ; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Harmon SA; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Phelps TE; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Garcia C; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Hazen LA; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Toubaji A; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Merino MJ; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Gurram S; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Choyke PL; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Wood BJ; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Pinto PA; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
  • Turkbey B; From the Molecular Imaging Branch (E.C.Y., M.J.B., S.A.H., T.E.P., P.L.C., B.T.), Biometric Research Program, Division of Cancer Treatment and Diagnosis (J.H.S.), Center for Interventional Oncology (C.G., L.A.H., B.J.W.), Department of Radiology, Clinical Center (C.G., L.A.H., B.J.W.), Laboratory of
Radiology ; 307(4): e221309, 2023 05.
Article em En | MEDLINE | ID: mdl-37129493
Background Data regarding the prospective performance of Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 alone and in combination with quantitative MRI features for prostate cancer detection is limited. Purpose To assess lesion-based clinically significant prostate cancer (csPCa) rates in different PI-RADS version 2.1 categories and to identify MRI features that could improve csPCa detection. Materials and Methods This single-center prospective study included men with suspected or known prostate cancer who underwent multiparametric MRI and MRI/US-guided biopsy from April 2019 to December 2021. MRI scans were prospectively evaluated using PI-RADS version 2.1. Atypical transition zone (TZ) nodules were upgraded to category 3 if marked diffusion restriction was present. Lesions with an International Society of Urological Pathology (ISUP) grade of 2 or higher (range, 1-5) were considered csPCa. MRI features, including three-dimensional diameter, relative lesion volume (lesion volume divided by prostate volume), sphericity, and surface to volume ratio (SVR), were obtained from lesion contours delineated by the radiologist. Univariable and multivariable analyses were conducted at the lesion and participant levels to determine features associated with csPCa. Results In total, 454 men (median age, 67 years [IQR, 62-73 years]) with 838 lesions were included. The csPCa rates for lesions categorized as PI-RADS 1 (n = 3), 2 (n = 170), 3 (n = 197), 4 (n = 319), and 5 (n = 149) were 0%, 9%, 14%, 37%, and 77%, respectively. csPCa rates of PI-RADS 4 lesions were lower than PI-RADS 5 lesions (P < .001) but higher than PI-RADS 3 lesions (P < .001). Upgraded PI-RADS 3 TZ lesions were less likely to harbor csPCa compared with their nonupgraded counterparts (4% [one of 26] vs 20% [20 of 99], P = .02). Predictors of csPCa included relative lesion volume (odds ratio [OR], 1.6; P < .001), SVR (OR, 6.2; P = .02), and extraprostatic extension (EPE) scores of 2 (OR, 9.3; P < .001) and 3 (OR, 4.1; P = .02). Conclusion The rates of csPCa differed between consecutive PI-RADS categories of 3 and higher. MRI features, including lesion volume, shape, and EPE scores of 2 and 3, predicted csPCa. Upgrading of PI-RADS category 3 TZ lesions may result in unnecessary biopsies. ClinicalTrials.gov registration no. NCT03354416 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Goh in this issue.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Imageamento por Ressonância Magnética Multiparamétrica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: Radiology Ano de publicação: 2023 Tipo de documento: Article
Texto completo
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Imageamento por Ressonância Magnética Multiparamétrica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male Idioma: En Revista: Radiology Ano de publicação: 2023 Tipo de documento: Article