Keywords:
Abdomen, Genital / Reproductive system male, Pelvis, MR, MR-Diffusion/Perfusion, Observer performance, Biopsy, Decision analysis, Cancer, Multidisciplinary cancer care, Pathology
Authors:
A. Labra Weitzler, F. Tapia, C. Silva, J. P. Olivares, A. Zuñiga; Santiago/CL
DOI:
10.26044/ecr2019/C-2160
Aims and objectives
PI-RADS is a guide for making a structured report and decreasing inter-observer variability
Management of PI-RADS 3 category patients is not well defined,
leaving the indication for biopsy solely to the urologist’s decision.
The positivity rate for clinically significant prostate cancer in PI-RADS 3 patients has been reported as 24.8%.
Fig. 1
Prostate cancer can be classified according to its histological pattern in low,
intermediate and high risk,
where the latter two are categorized as clinically significant.
Fig. 2
PSA values have been considered an inaccurate approach to diagnosis,
given the effect of factors such as age,
prostatic hyperplasia,
and subclinical prostatitis,
on its wide range of measurements.
Given that the approach for patients with a PI-RADS 3 result is not defined,
the use of a different measurement,
such as the PSA density (PSA value divided by the prostatic volume),
might improve the negative predictive value,
sensitivity and specificity.
Previous studies have proposed a cut-off value of PSA density of 0.15 (ng/ml/cc) to perform a biopsy,
thus reducing the number of unnecessary biopsies without compromising the detection of prostate cancer.
Fig. 3
The purpose of our study is to evaluate the role of PSA density derived by MRI on final diagnosis of cancer in PI-RADS 3 patients.