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Does 1.5 T mpMRI play a definite role in detection of clinically significant prostate cancer? Findings from a prospective study comparing blind 24-core saturation and targeted biopsies with a novel data remodeling model

  • Fabrizio Dal Moro
  • Giovanni Zecchini
  • Alessandro Morlacco
  • Marina Paola Gardiman
  • Carmelo Salvino Lacognata
  • Alberto Lauro
  • Massimo Rugge
  • Tommaso Prayer Galetti
  • Filiberto Zattoni
Original Article

Abstract

Background

Multiparametric-magnetic resonance imaging (mpMRI) can accurately detect high-grade and larger prostate cancers (PC).

Aims

To evaluate the ability of 1.5 T magnetic field mpMRI-targeted Prostate Biopsies (PBx) in predicting PC in comparison with blind 24-core saturation PBx (sPBx).

Methods

We prospectively collected data from patients undergoing transrectal sPBx and, if needed, targeted PBx of suspected lesions based on the 16-‘region-of-interest’ (ROI) PI-RADS graph. Data remodeling: for each ‘target’ (each suspected lesion at mpMRI), we identified all the 16 ‘ROIs’ into which the lesion extended: these single ‘ROIs’ were identified as ‘macro-targets’. For each ‘ROI’ and ‘macro-target’, we compared the mpMRI result with that of a saturation and targeted biopsy (if performed).

Results

1.5T mpMRI showed a PI-RADS value ≥ 3 in 101 patients (82.1%). We found a PC in 50 (40.6%). Negative-positive predictive values for mpMRI were 82–45%, respectively. Of the 22 patients with normal mpMRI, four had a PC, but none had a clinically significant cancer. After the data remodeling, we demonstrated the presence of PC in 228 ‘ROIs’: (a) only in targeted biopsies in 15 ‘ROIs’/’macro-targets’ (6.6%); (b) only in sPBx in 177 ‘ROIs’ (77.6%); (c) in both targeted and sPBx in 36 ‘ROIs’ (15.8%).

Discussion

81.8% of patients with normal 1.5T mpMRI were negative at PBx. Performing only targeted PBx may lead to lack of PC diagnosis in about 50% of patients.

Conclusions

In patients with suspected PC and a previous negative PBx, a normal mpMRI may exclude a clinically significant PC, avoiding sPBx.

Keywods

Multiparametric MRI Prostate cancer Prostate biopsy 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statement on the welfare of animals

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40520_2018_939_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 KB)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Fabrizio Dal Moro
    • 1
  • Giovanni Zecchini
    • 1
  • Alessandro Morlacco
    • 1
  • Marina Paola Gardiman
    • 2
  • Carmelo Salvino Lacognata
    • 3
  • Alberto Lauro
    • 3
  • Massimo Rugge
    • 2
  • Tommaso Prayer Galetti
    • 1
  • Filiberto Zattoni
    • 1
  1. 1.Department of Surgery, Oncology and Gastroenterology-UrologyUniversity of PadovaPaduaItaly
  2. 2.Department of PathologyAzienda Ospedaliera di PadovaPaduaItaly
  3. 3.Department of RadiologyAzienda Ospedaliera di PadovaPaduaItaly

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