Abstract
Introduction: Multiparametric MRI (mpMRI) is gold standard for the primary diagnostic work-up of clinically significant prostate cancer (csPCa). The aim of this study was to assess the benefit of the perfusion sequence and the non-inferiority of an MRI without contrast administration (bpMRI) compared to mpMRI while taking clinical parameters into account. Methods: In this retrospective, non-interventional study we examined MRI data from 355 biopsy-naïve patients, performed on a 3T MRI system, evaluated by a board-certified radiologist with over 10 years of experience with subsequent mpMRI-TRUS fusion biopsy. Discussion: Only 16/355 (4.5%) patients benefited from dynamic contrast enhanced. In only 3/355 (0.8%) patients, csPCa would have been missed in bpMRI. BpMRI provided sensitivity and specificity (81.4%; 79.4%) comparable to mpMRI (75.2%; 81.8%). Additionally, bpMRI and mpMRI were independent predictors for the presence of csPCa, individually (OR: 15.36; p < 0.001 vs. 12.15; p = 0.006) and after accounting for established influencing factors (OR: 12.81; p < 0.001 vs. 6.50; p = 0.012). When clinical parameters were considered, a more balanced diagnostic performance between sensitivity and specificity was found for mpMRI and bpMRI. Overall, PSA density showed the highest diagnostic performance (area under the curve = 0.81) for the detection of csPCa. Conclusion: The premise of the study was confirmed. Therefore, bpMRI should be adopted as soon as existing limitations have been lifted by prospective multi-reader studies.
Journal Section:
Research Article
References
1.
Kaatsch
P
, Spix
C
, Hentschel
S
, Katalinic
A
, Luttmann
S
, Stegmaier
C
, et al. Krebs in Deutschland 2009/2010 Eine gemeinsame Veröffentlichung des Robert Koch-Instituts und der Gesellschaft der epidemiologischen Krebsregister in Deutschland e
. 2013
.2.
Turkbey
B
, Rosenkrantz
AB
, Haider
MA
, Padhani
AR
, Villeirs
G
, Macura
KJ
, et al. Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2
. Eur Urol
. 2019
;76
(3
):340
–51
. 3.
Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Prostatakarzinom
. Langversion
Vol. 6.2
. 2021
retrieved on: 19.03.2023AWMF Registernummer: 043/022OL. Available from: http://www.leitlinienprogramm-onkologie.de/leitlinien/prostatakarzinom/4.
Kasivisvanathan
V
, Rannikko
AS
, Borghi
M
, Panebianco
V
, Mynderse
LA
, Vaarala
MH
, et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis
. N Engl J Med
. 2018
;378
(19
):1767
–77
. 5.
Schoots
IG
, Barentsz
JO
, Bittencourt
LK
, Haider
MA
, Macura
KJ
, Margolis
DJA
, et al. PI-RADS committee position on MRI without contrast medium in biopsy-naive men with suspected prostate cancer: narrative review
. AJR Am J Roentgenol
. 2021
;216
(1
):3
–19
. 6.
Bao
J
, Zhi
R
, Hou
Y
, Zhang
J
, Wu
C-J
, Wang
X-M
, et al. Optimized MRI assessment for clinically significant prostate cancer: a STARD-compliant two-center study
. J Magn Reson Imaging
. 2021
;53
(4
):1210
–9
. 7.
Jambor
I
, Verho
J
, Ettala
O
, Knaapila
J
, Taimen
P
, Syvänen
KT
, et al. Validation of IMPROD biparametric MRI in men with clinically suspected prostate cancer: a prospective multi-institutional trial
. PLoS Med
. 2019
;16
(6
):e1002813
. 8.
Scialpi
M
, Scialpi
P
, Martorana
E
, Torre
R
, Improta
A
, Aisa
MC
, et al. Simplified PI-RADS (S-PI-RADS) for biparametric MRI to detect and manage prostate cancer: what urologists need to know
. Turk J Urol
. 2021
;47
(3
):175
–82
. 9.
Belue
MJ
, Yilmaz
EC
, Daryanani
A
, Turkbey
B
. Current status of biparametric MRI in prostate cancer diagnosis: literature analysis
. Life
. 2022
;12
(6
):804
. 10.
Fascelli
M
, Rais-Bahrami
S
, Sankineni
S
, Brown
AM
, George
AK
, Ho
R
, et al. Combined biparametric prostate magnetic resonance imaging and prostate-specific antigen in the detection of prostate cancer: a validation study in a biopsy-naive patient population
. Urology
. 2016
;88
:125
–34
. 11.
Roh
AT
, Fan
RE
, Sonn
GA
, Vasanawala
SS
, Ghanouni
P
, Loening
AM
. How often is the dynamic contrast enhanced score needed in PI-RADS version 2
. Curr Probl Diagn Radiol
. 2020
;49
(3
):173
–6
. 12.
Han
C
, Liu
S
, Qin
XB
, Ma
S
, Zhu
LN
, Wang
XY
. MRI combined with PSA density in detecting clinically significant prostate cancer in patients with PSA serum levels of 4∼10 ng/mL: biparametric versus multiparametric MRI
. Diagn Interv Imaging
. 2020
;101
(4
):235
–44
. 13.
Russo
F
, Mazzetti
S
, Regge
D
, Ambrosini
I
, Giannini
V
, Manfredi
M
, et al. Diagnostic accuracy of single-plane biparametric and multiparametric magnetic resonance imaging in prostate cancer: a randomized noninferiority trial in biopsy-naïve men
. Eur Urol Oncol
. 2021
;4
(6
):855
–62
. 14.
Tamada
T
, Kido
A
, Yamamoto
A
, Takeuchi
M
, Miyaji
Y
, Moriya
T
, et al. Comparison of biparametric and multiparametric MRI for clinically significant prostate cancer detection with PI‐RADS version 2.1
. J Magn Reson Imaging
. 2021
;53
(1
):283
–91
. 15.
van der Leest
M
, Cornel
E
, Israël
B
, Hendriks
R
, Padhani
AR
, Hoogenboom
M
, et al. Head-to-head comparison of transrectal ultrasound-guided prostate biopsy versus multiparametric prostate resonance imaging with subsequent magnetic resonance-guided biopsy in biopsy-naïve men with elevated prostate-specific antigen: a large prospective multicenter clinical study
. Eur Urol
. 2019
;75
(4
):570
–8
. 16.
Woo
S
, Suh
CH
, Kim
SY
, Cho
JY
, Kim
SH
, Moon
MH
. Head-to-Head comparison between biparametric and multiparametric MRI for the diagnosis of prostate cancer: a systematic review and meta-analysis
. AJR Am J Roentgenol
. 2018
;211
(5
):W226
–w241
. 17.
Niu
X-K
, Chen
X-H
, Chen
Z-F
, Chen
L
, Li
J
, Peng
T
. Diagnostic performance of biparametric MRI for detection of prostate cancer: a systematic review and meta-analysis
. AJR Am J Roentgenol
. 2018
;211
(2
):369
–78
. 18.
Kang
Z
, Min
X
, Weinreb
J
, Li
Q
, Feng
Z
, Wang
L
. Abbreviated biparametric versus standard multiparametric MRI for diagnosis of prostate cancer: a systematic review and meta-analysis
. AJR Am J Roentgenol
. 2019
;212
(2
):357
–65
. 19.
Alabousi
M
, Salameh
J-P
, Gusenbauer
K
, Samoilov
L
, Jafri
A
, Yu
H
, et al. Biparametric vs multiparametric prostate magnetic resonance imaging for the detection of prostate cancer in treatment-naïve patients: a diagnostic test accuracy systematic review and meta-analysis
. BJU Int
. 2019
;124
(2
):209
–20
. 20.
Bass
EJ
, Pantovic
A
, Connor
M
, Gabe
R
, Padhani
AR
, Rockall
A
, et al. A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk
. Prostate Cancer Prostatic Dis
. 2021
;24
(3
):596
–611
. 21.
Liang
Z
, Hu
R
, Yang
Y
, An
N
, Duo
X
, Liu
Z
, et al. Is dynamic contrast enhancement still necessary in multiparametric magnetic resonance for diagnosis of prostate cancer: a systematic review and meta-analysis
. Transl Androl Urol
. 2020
;9
(2
):553
–73
. 22.
Franco
FB
, Fennessy
FM
. Arguments against using an abbreviated or biparametric prostate MRI protocol
. Abdom Radiol
. 2020
;45
(12
):3982
–9
. 23.
Xu
L
, Zhang
G
, Shi
B
, Liu
Y
, Zou
T
, Yan
W
, et al. Comparison of biparametric and multiparametric MRI in the diagnosis of prostate cancer
. Cancer Imag
. 2019
;19
(1
):90
. 24.
Brancato
V
, Di Costanzo
G
, Basso
L
, Tramontano
L
, Puglia
M
, Ragozzino
A
, et al. Assessment of DCE utility for PCa diagnosis using PI-RADS v2.1: effects on diagnostic accuracy and reproducibility
. Diagnostics
. 2020
;10
(3
):164
. 25.
Giganti
F
, Allen
C
, Emberton
M
, Moore
CM
, Kasivisvanathan
V
, PRECISION study group
. Prostate imaging quality (PI-QUAL): a new quality control scoring system for multiparametric magnetic resonance imaging of the prostate from the PRECISION trial
. Eur Urol Oncol
. 2020
;3
(5
):615
–9
. 26.
Stabile
A
, Giganti
F
, Kasivisvanathan
V
, Giannarini
G
, Moore
CM
, Padhani
AR
, et al. Factors influencing variability in the performance of multiparametric magnetic resonance imaging in detecting clinically significant prostate cancer: a systematic literature review
. Eur Urol Oncol
. 2020
;3
(2
):145
–67
. 27.
Barrett
T
, Ghafoor
S
, Gupta
RT
, Kim
CK
, Muglia
VF
, Macura
KJ
, et al, Prostate MRI Qualification: AJR Expert Panel Narrative Review
. Prostate MRI qualification: AJR expert panel narrative review
. AJR Am J Roentgenol
. 2022
;219
(5
):691
–702
. 28.
Asif
A
, Nathan
A
, Ng
A
, Khetrapal
P
, Chan
VW-S
, Giganti
F
, et al. Comparing biparametric to multiparametric MRI in the diagnosis of clinically significant prostate cancer in biopsy-naive men (PRIME): a prospective, international, multicentre, non-inferiority within-patient, diagnostic yield trial protocol
. BMJ Open
. 2023
;13
(4
):e070280
. © 2024 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2024
You do not currently have access to this content.
