Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV.

[1]  C C Schulman,et al.  Optimal predictors of prostate cancer on repeat prostate biopsy: a prospective study of 1,051 men. , 2000, The Journal of urology.

[2]  H. Hricak,et al.  Chronic prostatitis: MR imaging and 1H MR spectroscopic imaging findings--initial observations. , 2004, Radiology.

[3]  G. Herigault,et al.  [Predicting prostate cancer with dynamic endorectal coil MR and proton spectroscopic MR imaging]. , 2004, Journal de radiologie.

[4]  Helmut Ermert,et al.  Initial experiences with real-time elastography guided biopsies of the prostate. , 2005, The Journal of urology.

[5]  A. Levy,et al.  Prostate Cancer: Local Staging at 3-T Endorectal MR Imaging—Early Experience , 2006 .

[6]  D. Ornstein,et al.  Pain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomized trial of 6 versus 12 cores. , 2000, The Journal of urology.

[7]  K. Badani,et al.  Prospective evaluation of endorectal magnetic resonance imaging to detect tumor foci in men with prior negative prostastic biopsy: a pilot study. , 2000, The Journal of urology.

[8]  J. Hugosson,et al.  Follow-up of men with elevated prostate-specific antigen and one set of benign biopsies at prostate cancer screening. , 2003, European urology.

[9]  L. Kiemeney,et al.  A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer , 2006, European Radiology.

[10]  Olivier Rouvière,et al.  Characterization of time-enhancement curves of benign and malignant prostate tissue at dynamic MR imaging , 2003, European Radiology.

[11]  G Bartsch,et al.  Comparison of contrast enhanced color Doppler targeted biopsy to conventional systematic biopsy: impact on Gleason score. , 2007, The Journal of urology.

[12]  D. Regge,et al.  Value of endorectal MRI and MRS in patients with elevated prostate-specific antigen levels and previous negative biopsies to localize peripheral zone tumours. , 2008, Clinical radiology.

[13]  Jeffrey Busby,et al.  Determining variables for repeat prostate biopsy , 2004, Prostate Cancer and Prostatic Diseases.

[14]  Hideaki Miyake,et al.  Predictors of prostate cancer on repeat transrectal ultrasound‐guided systematic prostate biopsy , 2003, International journal of urology : official journal of the Japanese Urological Association.

[15]  A. Weaver,et al.  Prostate cancer diagnosis using a saturation needle biopsy technique after previous negative sextant biopsies. , 2001, The Journal of urology.

[16]  Heinz-Peter Schlemmer,et al.  MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. , 2006, European urology.

[17]  H. Huisman,et al.  Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. , 2006, Radiology.

[18]  Peter Guion,et al.  Initial clinical experience with real‐time transrectal ultrasonography‐magnetic resonance imaging fusion‐guided prostate biopsy , 2008, BJU international.

[19]  K. Shinohara,et al.  Prospective evaluation of lateral biopsies of the peripheral zone for prostate cancer detection. , 1998, The Journal of urology.

[20]  W S Ng,et al.  Endorectal magnetic resonance imaging and spectroscopy for the detection of tumor foci in men with prior negative transrectal ultrasound prostate biopsy. , 2004, The Journal of urology.

[21]  Jelle O. Barentsz,et al.  Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal–pelvic phased-array coils , 2007, European Radiology.

[22]  Koji Okihara,et al.  Predictors of cancer in repeat extended multisite prostate biopsy in men with previous negative extended multisite biopsy. , 2002, Urology.

[23]  J. Melamed,et al.  Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. , 1998, The Journal of urology.

[24]  J. Gore,et al.  Optimal combinations of systematic sextant and laterally directed biopsies for the detection of prostate cancer. , 2001, The Journal of urology.

[25]  Olivier Rouvière,et al.  Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable? , 2007, European Radiology.

[26]  A. Villers,et al.  Dynamic contrast enhanced, pelvic phased array magnetic resonance imaging of localized prostate cancer for predicting tumor volume: correlation with radical prostatectomy findings. , 2006, The Journal of urology.

[27]  Ashutosh Kumar Singh,et al.  Magnetic resonance imaging‐directed transrectal ultrasonography‐guided biopsies in patients at risk of prostate cancer , 2007, BJU international.

[28]  M. Terris,et al.  Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. , 1989, The Journal of urology.

[29]  Clare Allen,et al.  How good is MRI at detecting and characterising cancer within the prostate? , 2006, European urology.

[30]  Mesut Remzi,et al.  Can Power Doppler enhanced transrectal ultrasound guided biopsy improve prostate cancer detection on first and repeat prostate biopsy? , 2004, European urology.

[31]  Robert W Veltri,et al.  Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. , 2003, The Journal of urology.

[32]  Seong Ho Park,et al.  Wash‐in rate on the basis of dynamic contrast‐enhanced MRI: Usefulness for prostate cancer detection and localization , 2005, Journal of magnetic resonance imaging : JMRI.

[33]  Jonathan Ophir,et al.  Visualisation of HIFU lesions using elastography of the human prostate in vivo: preliminary results. , 2003, Ultrasound in medicine & biology.

[34]  Thomas Hambrock,et al.  Prostate cancer: body-array versus endorectal coil MR imaging at 3 T--comparison of image quality, localization, and staging performance. , 2007, Radiology.

[35]  Christopher R King,et al.  Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. , 2004, International journal of radiation oncology, biology, physics.

[36]  K. Yamada,et al.  Visualization of prostate cancer using dynamic contrast-enhanced MRI: comparison with transrectal power Doppler ultrasound. , 2003, The British journal of radiology.

[37]  D. Portalez,et al.  génito-urinaire - Détection du cancer de la prostate par IRM endorectale dynamique et spectroscopique-proton , 2004 .

[38]  T. Wheeler,et al.  Predictors of prostate cancer after initial negative systematic 12 core biopsy. , 2004, The Journal of urology.

[39]  M. Remzi,et al.  When to biopsy and when to stop biopsying. , 2003, The Urologic clinics of North America.

[40]  George R. Dakwar,et al.  Controversies in Transrectal Ultrasonography and Prostate Biopsy , 2006, Ultrasound quarterly.

[41]  Olivier Rouvière,et al.  Prostate MR imaging at high-field strength: evolution or revolution? , 2006, European Radiology.

[42]  Bernd Hamm,et al.  Patients with a history of elevated prostate-specific antigen levels and negative transrectal US-guided quadrant or sextant biopsy results: value of MR imaging. , 2002, Radiology.

[43]  Evis Sala,et al.  Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. , 2006, Radiology.

[44]  G. Bartsch,et al.  Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer , 2007, Current opinion in urology.

[45]  Rodolfo Montironi,et al.  Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. , 2007, European urology.