Comparison between multiparametric MRI with and without post - contrast sequences for clinically significant prostate cancer detection
Int. braz. j. urol
; 44(6): 1129-1138, Nov.-Dec. 2018. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-975650
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Background:
Dynamic-contrast enhanced (DCE) sequence is used to increase detection of small lesions, based on increased vascularization. However, literature is controversy about the real incremental value of DCE in detection of clinically significant (CS) prostate cancer (PCa), since absence of enhancement does not exclude cancer, and enhancement alone is not definitive for tumor.Purpose:
To test the hypothesis that DCE images do not increase CS PCa detection on MRI prior to biopsy, comparing exams without and with contrast sequences. Material and Materials andMethods:
All men who come to our institution to perform MRI on a 3T scanner without a prior diagnosis of CS PCa were invited to participate in this study. Reference standard was transrectal prostate US with systematic biopsy and MRI/US fusion biopsy of suspicious areas. Radiologists read the MRI images prospectively and independently (first only sequences without contrast, and subsequently the entire exam) and graded them on 5-points scale of cancer suspicion.Results:
102 patients were included. Overall detection on biopsy showed CS cancer in 43 patients (42.2%), clinically non-significant cancer in 11 (10.8%) and negative results in 48 patients (47%). Positivities for CS PCa ranged from 8.9% to 9.8% for low suspicion and 75.0% to 88.9% for very high suspicion. There was no statistical difference regarding detection of CS PCa (no statistical difference was found when compared accuracies, sensitivities, specificities, PPV and NPV in both types of exams). Inter-reader agreement was 0.59.Conclusion:
Exams with and without contrast-enhanced sequences were similar for detection of CS PCa on MRI.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Neoplasias da Próstata
/
Imageamento por Ressonância Magnética
/
Meios de Contraste
Tipo de estudo:
Estudo diagnóstico
Limite:
Adulto
/
Idoso
/
Idoso, 80 anos ou mais
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Hospital Israelita Albert Einstein/BR