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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

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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.

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Funding

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

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Authors and Affiliations

  1. Department of Surgery, Oncology and Gastroenterology-Urology, University of Padova, Via Giustiniani 2, 35128, Padua, Italy

    Fabrizio Dal Moro, Giovanni Zecchini, Alessandro Morlacco, Tommaso Prayer Galetti & Filiberto Zattoni

  2. Department of Pathology, Azienda Ospedaliera di Padova, Padua, Italy

    Marina Paola Gardiman & Massimo Rugge

  3. Department of Radiology, Azienda Ospedaliera di Padova, Padua, Italy

    Carmelo Salvino Lacognata & Alberto Lauro

Authors
  1. Fabrizio Dal Moro
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  2. Giovanni Zecchini
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  3. Alessandro Morlacco
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  4. Marina Paola Gardiman
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  5. Carmelo Salvino Lacognata
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  6. Alberto Lauro
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  7. Massimo Rugge
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  8. Tommaso Prayer Galetti
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  9. Filiberto Zattoni
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Corresponding author

Correspondence to Fabrizio Dal Moro.

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The authors declare that they have no conflict of interest.

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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.

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

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

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Dal Moro, F., Zecchini, G., Morlacco, A. et al. 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. Aging Clin Exp Res 31, 115–123 (2019). https://doi.org/10.1007/s40520-018-0939-4

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  • DOI: https://doi.org/10.1007/s40520-018-0939-4

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