PCA is the most common cancer for men in Europe. Current gold standard for verification is ultrasound guided biopsy of the prostate gland. Relevance of multiparametric MRI-analysis is increasing so the MR-guided biopsies do. Study aimed to verify the diagnostic potential of recently established PIRADS-score compared to the histopathological outcome of MR-guided biopsy at 3T. A comparison of imaging and histopathological outcome wasdone at 3T-based MR-guided prostate biopsies to verify the diagnostic relevance of T2w vs. DWI/ADC vs. dynamic analysis in the multiparametric analysis of...

189 prostatic lesions were histologically verified by MR-guided biopsy (3T Philips Ingenia). Indication for biopsy was an inconclusive ultrasound guided biopsy and a suspicious multiparametric MRI. T2w wasobtained in 3 dimension;dynamic analysis (overall duration >5min, single dynamic scan of the entire gland <13s) was analyzed by CAD (Confirma and DynaCAD). DWI/ADC were calculated using B-values up to 1000. Lesions with PIRADS 4 or 5 were biopsied. PIRADS-schgeme of all single analyses were matched to the histopathological outcome. Related slides explain the principle of PIRADS as...

71/189 lesions were proven invasive-malignant and 14/189 lesions as ASAP. 39/189 lesions were verified as prostatitis, 31/189 as hyperplasia, 29/189 as atrophic prostatic tissue or other benign prostatic pathology. In 5/189 biopsies paraglandular tissue was found. No complication occurred at all. 24% of the histologically verified lesions were located in the central zone. T2w finding was scored as 4 or 5 points in 159 cases (sens: 50.9%; spec: 86.7%); sensitivity and specificity of DWI/ADC-calculation was 60.4%; spec: 63.4% and for dynamic analysis 50.4% and 60.5%,...

MR-guided prostate biopsy is a safe and useful intervention especially after inconclusive ultrasound guided biopsy of the prostate gland. PI-RADS-scoring according to T2w-data is more accurate for determination of malignancy, multiparametric analysis is, however essential to improve the specificity especially of the central zone. The semiquantitative CAD-based scoring of prostate lesions is less accurate and less specific. Further parameters such as slope or amount of peak uptake as well as Kep might be helpful to improve diagnostic potential of dynamic prostate MRI.

It would be a pleasure to get in contact with you. Thynk you for your interest. Please contact me as follows: Prof. Dr. med. habil Ansgar Malich Dr.-R.-Koch-Str. 39 99734 Nordhausen Institute of Radiology Sueharz-HOspital Nordhausen Germany [email protected] fon: ++49 3631412858

given in the slides. For more detailed information feel free to get in touch with me.