Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population
Objective: To evaluate the efficacy of multiparametric magnetic resonance imaging (mp-MRI) using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) definitions in detecting organ-confined prostate cancer. Methods: All patients who underwent radical prostatectomy between January 1, 20...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-07-01
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| Series: | Asian Journal of Urology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388218300390 |
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| author | Edwin Jonathan Aslim Yan Mee Law Puay Hoon Tan John Carson Allen, Jr. Lionel Tim-Ee Cheng Viswanath Anand Chidambaram Li Yan Khor Benjamin Yongcheng Tan Ernest Wencong Eu Christopher Wai Sam Cheng John Shyi Peng Yuen Henry Sun Sien Ho Lui Shiong Lee |
| author_facet | Edwin Jonathan Aslim Yan Mee Law Puay Hoon Tan John Carson Allen, Jr. Lionel Tim-Ee Cheng Viswanath Anand Chidambaram Li Yan Khor Benjamin Yongcheng Tan Ernest Wencong Eu Christopher Wai Sam Cheng John Shyi Peng Yuen Henry Sun Sien Ho Lui Shiong Lee |
| author_sort | Edwin Jonathan Aslim |
| collection | DOAJ |
| description | Objective: To evaluate the efficacy of multiparametric magnetic resonance imaging (mp-MRI) using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) definitions in detecting organ-confined prostate cancer. Methods: All patients who underwent radical prostatectomy between January 1, 2014 and December 30, 2014 were identified. All underwent mp-MRI within 180 days before surgery. Those with prior pelvic irradiation or androgen deprivation therapy were excluded. Fully embedded, whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location, Gleason score (GS) and stage. Results: There were 39 patients included, of which 35 (90%) had mp-MRI done post-biopsy. A total of 93 cancer foci were identified on whole-mount pathology, of which mp-MRI detected 63 (68%). Of those detected by mp-MRI, 14 were PI-RADS 3 (n = 6 for GS 6, n = 8 for GS 7, no GS ≥ 8) and 49 were PI-RADS 4–5 (n = 7 for GS 6, n = 33 for GS 7, and n = 9 for GS ≥ 8). There were 30 (32%) cancer foci missed by mp-MRI (n = 15 for GS 6, n = 13 for GS 7 and n = 2 for GS ≥ 8). A lesion classified as PI-RADS 4–5 predicted a higher grade cancer on pathology as compared to PI-RADS 3 (for GS 7 lesions, odds ratio [OR] = 3.53, 95% CI: 0.93–13.45, p = 0.064). The mp-MRI size detection limit was 20 mm2 and 100 mm2 for 50% and 75% probability of cancer, respectively. In associating with radiological and pathologic stage, the weighted Kappa value was 0.69 (p < 0.0001). The sensitivity and positive predictive values for this study were 68% (95% CI: 57%–77%) and 78% (95% CI: 67%–86%), respectively. Conclusion: In this predominantly post-biopsy cohort, mp-MRI using PI-RADSv2 reporting has a reasonably high diagnostic accuracy in detecting clinically significant prostate cancer. Keywords: Gleason score, Histopathology, Magnetic resonance imaging, Prostatectomy, Prostatic cancer |
| format | Article |
| id | doaj-art-db960fa8302147bd8776cc2eafafa3d8 |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-db960fa8302147bd8776cc2eafafa3d82025-08-20T03:24:51ZengElsevierAsian Journal of Urology2214-38822019-07-016325626310.1016/j.ajur.2018.05.008Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient populationEdwin Jonathan Aslim0Yan Mee Law1Puay Hoon Tan2John Carson Allen, Jr.3Lionel Tim-Ee Cheng4Viswanath Anand Chidambaram5Li Yan Khor6Benjamin Yongcheng Tan7Ernest Wencong Eu8Christopher Wai Sam Cheng9John Shyi Peng Yuen10Henry Sun Sien Ho11Lui Shiong Lee12Department of Urology, Singapore General Hospital, SingaporeDepartment of Diagnostic Radiology, Singapore General Hospital, SingaporeDivision of Pathology, Singapore General Hospital, SingaporeCentre of Quantitative Medicine, DUKE-NUS Medical School, SingaporeDepartment of Diagnostic Radiology, Singapore General Hospital, SingaporeDepartment of Diagnostic Radiology, Singapore General Hospital, SingaporeDepartment of Anatomical Pathology, Singapore General Hospital, SingaporeDepartment of Anatomical Pathology, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, Singapore; Corresponding author.Objective: To evaluate the efficacy of multiparametric magnetic resonance imaging (mp-MRI) using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) definitions in detecting organ-confined prostate cancer. Methods: All patients who underwent radical prostatectomy between January 1, 2014 and December 30, 2014 were identified. All underwent mp-MRI within 180 days before surgery. Those with prior pelvic irradiation or androgen deprivation therapy were excluded. Fully embedded, whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location, Gleason score (GS) and stage. Results: There were 39 patients included, of which 35 (90%) had mp-MRI done post-biopsy. A total of 93 cancer foci were identified on whole-mount pathology, of which mp-MRI detected 63 (68%). Of those detected by mp-MRI, 14 were PI-RADS 3 (n = 6 for GS 6, n = 8 for GS 7, no GS ≥ 8) and 49 were PI-RADS 4–5 (n = 7 for GS 6, n = 33 for GS 7, and n = 9 for GS ≥ 8). There were 30 (32%) cancer foci missed by mp-MRI (n = 15 for GS 6, n = 13 for GS 7 and n = 2 for GS ≥ 8). A lesion classified as PI-RADS 4–5 predicted a higher grade cancer on pathology as compared to PI-RADS 3 (for GS 7 lesions, odds ratio [OR] = 3.53, 95% CI: 0.93–13.45, p = 0.064). The mp-MRI size detection limit was 20 mm2 and 100 mm2 for 50% and 75% probability of cancer, respectively. In associating with radiological and pathologic stage, the weighted Kappa value was 0.69 (p < 0.0001). The sensitivity and positive predictive values for this study were 68% (95% CI: 57%–77%) and 78% (95% CI: 67%–86%), respectively. Conclusion: In this predominantly post-biopsy cohort, mp-MRI using PI-RADSv2 reporting has a reasonably high diagnostic accuracy in detecting clinically significant prostate cancer. Keywords: Gleason score, Histopathology, Magnetic resonance imaging, Prostatectomy, Prostatic cancerhttp://www.sciencedirect.com/science/article/pii/S2214388218300390 |
| spellingShingle | Edwin Jonathan Aslim Yan Mee Law Puay Hoon Tan John Carson Allen, Jr. Lionel Tim-Ee Cheng Viswanath Anand Chidambaram Li Yan Khor Benjamin Yongcheng Tan Ernest Wencong Eu Christopher Wai Sam Cheng John Shyi Peng Yuen Henry Sun Sien Ho Lui Shiong Lee Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population Asian Journal of Urology |
| title | Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population |
| title_full | Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population |
| title_fullStr | Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population |
| title_full_unstemmed | Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population |
| title_short | Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population |
| title_sort | multiparametric mri reporting using prostate imaging reporting and data system version 2 0 pi radsv2 retains clinical efficacy in a predominantly post biopsy patient population |
| url | http://www.sciencedirect.com/science/article/pii/S2214388218300390 |
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