Value of prostate multiparametric magnetic resonance imaging for predicting biopsy results in first or repeat biopsy.

AIM: To assess multiparametric magnetic resonance imaging (mp-MRI) in predicting prostate biopsy results. MATERIALS AND METHODS: Patients who underwent mp-MRI prior to prostate biopsy were prospectively included. The prostate was subdivided into 14 sectors and mp-MRI findings assessed using a five-level subjective suspicion score (SSS). Biopsy included targeted samples of abnormal sectors and systematic samples of normal peripheral zone sectors. RESULTS: Two hundred and eighty-eight patients were included [153 biopsy naïve, 135 with negative (n = 51) or positive (n = 84) prior biopsy]. Biopsy was positive in 168 patients. mp-MRI area under the receiver operating characteristic (ROC) curve (AUC) was 69.1% (95% CI: 67.1-70.9%), 72.5% (95% CI: 69.5-76%), and 73.8% (95% CI: 68.3-79.3%) at per sector, per lobe, and per patient analysis, respectively. At the per sector level, the AUC was significantly larger if detection was limited to cancers with a Gleason score of ≥7 (72.6%; 95% CI: 69.8-75.8%; p < 0.01) or ≥8 (87.1%; 95% CI: 78.3-95.7%; p < 0.01). mp-MRI performance was significantly influenced by prostate volume (p = 0.02), the presence of a concordant hypoechoic area (p < 0.001), but not by prostate-specific antigen (PSA) value, status of prior biopsy, or radiologists' experience. SSS was significantly associated with the Gleason score in true-positive lobes and patients (p < 0.0001). Using a SSS threshold of ≥3, cancer was missed in 13/102 lobes and 4/72 patients with cancers of Gleason score ≥7. CONCLUSION: mp-MRI provides a good detection of cancers with a Gleason score of ≥7 in candidates suitable for prostate biopsy.

[Diagnosis of cardiac amyloidosis using magnetic resonance imaging: a new reliable, non-invasive technique to be validated]. / Diagnostic de l'amylose cardiaque par imagerie par résonnance magnétique nucléaire : une nouvelle méthode fiable, non invasive, en cours de validation.

INTRODUCTION: Amyloidosis is characterised by extracellular tissue deposition of insoluble fibrillar protein in various organs. Cardiac involvement is associated with the worse prognosis and the main cause of death. It needs a prompt diagnosis, which could be sometimes difficult to obtain. Endomyocardial biopsy remains the gold standard diagnostic technique, but recent studies on cardiac magnetic resonance imaging (MRI) indicate that this imaging procedure may be useful to the diagnosis of amyloidosis. CASE REPORTS: We report three patients with systemic amyloidosis who underwent cardiac MRI for the diagnosis or the follow-up of their disease. In addition to poorly specific signs of restrictive cardiomyopathy, cardiac MRI showed, after gadolinium enhancement that was considered characteristic of amyloidosis. CONCLUSION: Cardiac MRI is a useful diagnostic tool in cardiac amyloidosis, as it was shown in recent studies. Compared to endomyocardial biopsy it is a non-invasive technique that is now more readily accessible and that seems to have an acceptable specificity.