Prospective comparison of a fast 1.5-T biparametric with the 3.0-T multiparametric ESUR magnetic resonance imaging protocol as a triage test for men at risk of prostate cancer
Abstract
To compare prospectively the diagnostic performance of a biparametric (T2-weighted imaging [T2WI] and diffusion-weighted imaging [DWI]) 1.5-T fast magnetic resonance imaging (fMRI) protocol with the standard 3.0-T multiparametric MRI (mpMRI) protocol of the European Society of Urological Imaging (ESUR) in men referred for a prostate biopsy. Ninety patients with a prostate cancer (PCa) risk of ≥10% according to the SWOP calculator 4 underwent first fMRI and then the reference mpMRI. Patients with Prostate Imaging Reporting and Data System (PI-RADS) v.2 lesions ≥3/5 on the mpMRI were scheduled for MRI/ultrasonography (US) fusion-guided prostate biopsy. Performance of fMRI was assessed using receiver-operating characteristic curve analysis and mpMRI as reference. Calculation of inter-technique agreement on PI-RADS v.2 score by Cohen's κ. The diagnostic accuracy of fMRI shown by the lesion-based analysis was excellent: area under the curve (AUC) 0.961 (P < 0.001), sensitivity 95%, specificity 97%, positive predictive value (PPV) 99%, negative predictive value (NPV) 89%. The patient-based analysis showed an AUC for fMRI of 0.975 (P < 0.001), a sensitivity of 98%, a specificity of 97%, a PPV of 98% and an NPV of 97%. Agreement on the...Continue Reading
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