Performance of mpMRI in Identifying Prostate Cancer

What is it about?

This study evaluated the performance of multiparametric magnetic resonance imaging (mpMRI) in identifying intraprostatic tumour deposits using a systematic and targeted MR-guided transperineal prostate biopsy technique. A total of 125 patients underwent the biopsy procedure. The positive predictive value (PPV) of mpMRI per patient was 59% for any cancer and 49% for Gleason score (GS) ≥ 7 cancer. The negative predictive value (NPV) of mpMRI per patient was 67% for any cancer and 88% for GS ≥ 7 cancer. On a per lesion basis, the PPV of PI-RADS 3 lesions for any and GS ≥ 7 cancer was 24% and 10%. For PI-RADS 4 lesions it was 42% and 32%. For PI-RADS 5 lesions, it was 76% and 70%. MpMRI failed to identify GS ≥ 7 cancer found on systematic biopsy in 22% of patients. Therefore, it would not be advisable to rely solely on mpMRI to target areas within the prostate and pathologic confirmation using both targeted and systematic mapping biopsy prior to focal therapy procedures should be performed.

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Why is it important?

This research is important because it evaluates the performance of multiparametric magnetic resonance imaging (mpMRI) in identifying intraprostatic tumor deposits using a systematic and targeted MR-guided transperineal prostate biopsy technique. The study provides valuable insights into the diagnostic reliability of mpMRI and its ability to identify clinically significant prostate cancer. It also emphasizes the importance of pathologic confirmation using both targeted and systematic mapping biopsy to accurately identify all intraprostatic tumor deposits. Key Takeaways: 1. The positive predictive value (PPV) of mpMRI per patient was 59% for any cancer and 49% for Gleason score (GS) ≥ 7 cancer. 2. The negative predictive value (NPV) of mpMRI per patient was 67% for any cancer and 88% for Gleason score (GS) ≥ 7 cancer. 3. On a per lesion basis, the PPV of PI-RADS 3 lesions for any and GS ≥ 7 cancer was 24% and 10%. For PI-RADS 4 lesions, it was 42% and 32%. For PI-RADS 5 lesions, it was 76% and 70%. 4. MpMRI failed to identify GS ≥ 7 cancer found on systematic biopsy in 22% of patients. 5. The PPV of mpMRI on a per lesion basis increased with increasing PI-RADS score. 6. A significant number of both false positive and false negative (mpMRI invisible) areas within the prostate contained GS ≥ 7 prostate cancer.