Keywords:
Genital / Reproductive system male, Pelvis, MR, MR-Diffusion/Perfusion, MR-Spectroscopy, Observer performance, Outcomes analysis, Structured reporting, Cancer
Authors:
D. Gutierrez, O. Chirife, C. Pineda; Barcelona/ES
DOI:
10.1594/ecr2013/C-0968
Results
Population:
- 14 patients with a mean age of 66.78 +/-6.38 (range 54-76 years)
- At least one previous negative TRUS biopsy.
Mean number of biopsies 3.64 (range 1-6).
- PSA previous to the mpMRI was elevated in all the patients.
Mean value 20.59+/-10.67 (range 7.77-52.61).
- All patients underwent biopsy following MRI with a median interval of 94.71 days +/-90.67 (range 8-287).
The biopsy was positive for cancer in 6 patients (42.85%).
The maximal Gleason score was 4+5 (n=1),
4+3 (n=2),
3+4 (n=1),
3+3 (n=2).
Patients with negative biopsies continued clinical follow up,
with a control mpMRI in two of them.
MULTIPARAMETRIC MRI
Figure 1 depicts a mpMRI study with a high PI-RADS score and positive biopsy for prostatic carcinoma.
Figure 2 depicts a mpMRI study with a low PI-RADS score and positive biopsy for prostatic carcinoma.
Please refer to the annotations for further information.
PI-RADS SCORE AND INTERRATER RELIABILITY: The highest interrater reliability was found to be Kappa = 0.778 for the T2w score and Kappa= 0.644 for the DCE sequence.
The Kappa for the total score was 0.526 (95% CI 0.355,
0.697).
MRI sequence
|
Weighted kappa
|
T2w image
|
0.778
|
DWI
|
0.417
|
DCE
|
0.644
|
Spectroscopy
|
0.596
|
Total score
|
0.526
|
PI-RADS SCORE AND RELATIONSHIP WITH BIOPSY: The data from the two readers was analyzed independently as well as pooled.
Higher PI-RADS scores were observed in positive biopsies for the T2 and DWI score (P<0.05),
with a tendency in the total score (P=0.071) No statistically significant difference was observed in the other subscores.
Pooled data
Multiparametric magnetic resonance imaging characteristics of 14 biopsies,
as a function of the presence or abscence of prostate cancer |
|
Negative biopsies n=8 |
Positive biopsies n=6 |
p value |
T2 score (1-5) |
2 (95% CI 2,
3) |
4.25 (95% CI 2.38,
5) |
0.0146 |
DWI score (1-5) |
2.5 (95% CI 1,
3.68) |
4.5 (95% CI3.19,
4.9) |
0.0136 |
DCE score (1-5) |
2.25 (95% CI 1.9,
4) |
3.75 (95% CI 1.29,
4) |
0.327 |
Spectroscopy score (1-5) |
2.25 (95% CI 1,4.09) |
2.5 (95% CI 1,
4.3) |
0.8968 |
Sum of scores (4-20) |
9.75 (95% CI 8.31,
11.16) |
14.5 (95% CI 8.1,
17.5) |
0.0704 |
Fig. 3: Pooled data
References: Diego Gutierrez
Independent data
Fig. 4: Independent data
References: Diego Gutierrez