Save
SIU-WJU Article of the Month – June 2019
Clinical applications of multiparametric MRI within the prostate cancer diagnostic pathway
SIU Academy®. Ren S. Jun 4, 2019; 273470
Login now to access Regular content available to all registered users.

To have an exclusive access to the entire content available on SIU Academy, become an SIU Member here.

You may also access SIU content "anytime, anywhere" with the FREE SIU ACADEMY App for iOS and Android.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Purpose

Multiparametric magnetic resonance imaging (mpMRI) improves clinically significant prostate cancer (csPCa)
detection by facilitating targeted biopsy (cognitive, fusion technology, or in-gantry MRI guidance) and reducing negative
biopsies. This study sought to describe the feasibility of introducing an mpMRI-based triage pathway, including diagnostic performance, applicability to training, and cost analysis.

Methods

An observational retrospective cohort study of consecutive patients attending a large public tertiary referral training
hospital who underwent mpMRI for suspicion of prostate cancer was considered. Standard clinical, MRI-related, histopathological, and financial parameters were collected for analysis of biopsy avoidance, diagnostic accuracy of biopsy approach, and operator (consultant and resident/registrar) and logistical (including financial) feasibility.

Results

653 men underwent mpMRI, of which 344 underwent prostate biopsy resulting in a 47% biopsy avoidance rate.
Overall, 240 (69.8%) patients were diagnosed with PCa, of which 208 (60.5%) were clinically significant, with higher rates of csPCa observed for higher PIRADS scores. In patients who underwent both systematic and targeted biopsy (stTPB), targeted cores detected csPCa in 12.7% and 16.6% in more men than systematic cores in PIRADS 5 and 4, respectively, whereas systematic cores detected csPCa in 5% and 3.2% of patients, where targeted cores did not. A high standard of performance was maintained across the study period and the approach was shown to be cost effective.

Conclusions

Introdution of an mpMRI-based triage system into a large public tertiary teaching hospital is feasible, cost
effective and leads to high rates of prostate cancer diagnosis while reducing unnecessary biopsies and detection of insignificant PCa.

Keywords

Prostate cancer · Multiparametric MRI · Transperineal prostate biopsy · Cognitive-fusion prostate biopsy ·
Systematic prostate biopsy · Prostate imaging reporting and data system
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings