MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy

作者：Schimmoeller Lars; Quentin Michael^*; Arsov Christian; Hiester Andreas; Buchbender Christian; Rabenalt Robert; Albers Peter; Antoch Gerald; Blondin Dirk

来源：European Radiology, 2014, 24(10): 2582-2589.

DOI：10.1007/s00330-014-3276-9

• Prostate cancer
• MRI
• PI-RADS
• MR sequences
• MR-guided in-bore biopsy

This study evaluated the accuracy of MR sequences [T2-, diffusion-weighted, and dynamic contrast-enhanced (T2WI, DWI, and DCE) imaging] at 3T, based on the European Society of Urogenital Radiology (ESUR) scoring system [Prostate Imaging Reporting and Data System (PI-RADS)] using MR-guided in-bore prostate biopsies as reference standard. %26lt;br%26gt;In 235 consecutive patients [aged 65.7 +/- 7.9 years; median prostate-specific antigen (PSA) 8 ng/ml] with multiparametric prostate MRI (mp-MRI), 566 lesions were scored according to PI-RADS. Histology of all lesions was obtained by targeted MR-guided in-bore biopsy. %26lt;br%26gt;In 200 lesions, biopsy revealed prostate cancer (PCa). The area under the curve (AUC) for cancer detection was 0.70 (T2WI), 0.80 (DWI), and 0.74 (DCE). A combination of T2WI + DWI, T2WI + DCE, and DWI + DCE achieved an AUC of 0.81, 0.78, and 0.79. A summed PI-RADS score of T2WI + DWI + DCE achieved an AUC of 0.81. For higher grade PCa (primary Gleason pattern a parts per thousand yenaEuro parts per thousand 4), the AUC was 0.85 for T2WI + DWI, 0.84 for T2WI + DCE, 0.86 for DWI + DCE, and 0.87 for T2WI + DWI + DCE. The AUC for T2WI + DWI + DCE for transitional-zone PCa was 0.73, and for the peripheral zone 0.88. Regarding higher-grade PCa, AUC for transitional-zone PCa was 0.88, and for peripheral zone 0.96. %26lt;br%26gt;The combination of T2WI + DWI + DCE achieved the highest test accuracy, especially in patients with higher-grade PCa. The use of a parts per thousand currency sign2 MR sequences led to lower AUC in higher-grade and peripheral-zone cancers. %26lt;br%26gt;aEuro cent T2WI + DWI + DCE achieved the highest accuracy in patients with higher grade PCa %26lt;br%26gt;aEuro cent T2WI + DWI + DCE was more accurate for peripheral- than for transitional-zone PCa %26lt;br%26gt;aEuro cent DCE increased PCa detection accuracy in the peripheral zone %26lt;br%26gt;aEuro cent DWI was the leading sequence in the transitional zone.

• 出版日期2014-10