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Keywords:
Outcomes analysis, Imaging sequences, MR-Diffusion/Perfusion, MR, Pelvis, Oncology, Diagnostic procedure, Neoplasia, Outcomes
Authors:
L. Basso, L. Secondini, S. Barbagallo, I. Verardo, C. bergaglio, F. Rosa, C. E. Neumaier; Genova/IT
DOI:
10.1594/ecr2017/C-0705
Conclusion
Our findings indicate that both quantitative parameters (ADC and TTP) can predict malignant histology and MRI is a valuable technique to identify high-risk suspicious lesions.
However,
DWI-based quantitative measurement exhibits a stronger association with biopsy findings than TTP.
This means that,
if compared to TTP,
ADC values,
due to its direct correlation with GS,
is able to better define tumour aggressiveness.
Since this study was not intended to investigate the primary detection rate of MRI but its grading ability,
matching of imaging with prostatectomy specimens seemed to be best qualified for this aim.
With the intent to fix this limit,
lesions were matched on a subjective basis in consensus of the pathologist and radiologist to minimize these inaccuracies.
Another limitation of our study might be related to the distribution of GS in our subgroup of patients,
with the majority of identified foci (63,2%) being of low and intermediate risk.
To address this issue,
we dichotomized the score variable,
leading to a binary target variable (GS < 6 representing indolent cancer and GS ≥ 6 representing intermediate and high risk cancer).
However the numbers of GS=8 and GS=9 were still smaller comparing to GS=6 and GS=7.
Moreover,
the major parts of identified foci were in PZ,
and only a smaller part in TZ.
In conclusion,
our study is a quantitative and statistical demonstration of the reason why a mp-MRI could be favourably performed omitting DCE in the single indication of tumour detection,
reserving contrast-enhanced sequences for other indications (i.e.
detection of local recurrence).
Further studies are needed to confirm our results and evaluate the possibility of favourable application of a biparametric protocol.