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Guljaš S, Benšić M, Krivdić Dupan Z, Pavlović O, Krajina V, Pavoković D, Šmit Takač P, Hranić M, Salha T. Dynamic Contrast Enhanced Study in Multiparametric Examination of the Prostate—Can We Make Better Use of It? Tomography 2022; 8:1509-1521. [PMID: 35736872 PMCID: PMC9231365 DOI: 10.3390/tomography8030124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/18/2022] [Accepted: 06/04/2022] [Indexed: 11/16/2022] Open
Abstract
We sought to investigate whether quantitative parameters from a dynamic contrast-enhanced study can be used to differentiate cancer from normal tissue and to determine a cut-off value of specific parameters that can predict malignancy more accurately, compared to the obturator internus muscle as a reference tissue. This retrospective study included 56 patients with biopsy proven prostate cancer (PCa) after multiparametric magnetic resonance imaging (mpMRI), with a total of 70 lesions; 39 were located in the peripheral zone, and 31 in the transition zone. The quantitative parameters for all patients were calculated in the detected lesion, morphologically normal prostate tissue and the obturator internus muscle. Increase in the Ktrans value was determined in lesion-to-muscle ratio by 3.974368, which is a cut-off value to differentiate between prostate cancer and normal prostate tissue, with specificity of 72.86% and sensitivity of 91.43%. We introduced a model to detect prostate cancer that combines Ktrans lesion-to-muscle ratio value and iAUC lesion-to-muscle ratio value, which is of higher accuracy compared to individual variables. Based on this model, we identified the optimal cut-off value with 100% sensitivity and 64.28% specificity. The use of quantitative DCE pharmacokinetic parameters compared to the obturator internus muscle as reference tissue leads to higher diagnostic accuracy for prostate cancer detection.
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Affiliation(s)
- Silva Guljaš
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
- Correspondence:
| | - Mirta Benšić
- Department of Mathematics, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Zdravka Krivdić Dupan
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Oliver Pavlović
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Vinko Krajina
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Deni Pavoković
- Department of Urology, University Hospital Centre Osijek, 31000 Osijek, Croatia; (O.P.); (V.K.); (D.P.)
| | - Petra Šmit Takač
- Clinical Department of Surgery, Osijek University Hospital Centre, 31000 Osijek, Croatia;
| | - Matija Hranić
- Clinical Department of Radiology, University Hospital Centre, 31000 Osijek, Croatia; (Z.K.D.); (M.H.)
| | - Tamer Salha
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Department of Teleradiology and Artificial Intelligence, Health Centre Osijek-Baranja County, 31000 Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Zhu J, Liang Z, Song Y, Yang Y, Xu Y, Lu Y, Hu R, Ou N, Zhang W, Liu X. Can the combination of biparametric magnetic resonance imaging and PSA-related indicators predict the prostate biopsy outcome? Andrologia 2020; 52:e13734. [PMID: 32609397 DOI: 10.1111/and.13734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 04/18/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022] Open
Abstract
To assess the value of biparametric magnetic resonance imaging (bpMRI) for detecting and ruling out prostate cancer in patients with elevated prostate-specific antigen (PSA). The basic information and bpMRI images of enrolled patients who took transperineal template saturate biopsy were retrospectively collected for analysis. Based on our results, we found that free/total PSA, and PI-RADS score were independent risk factors of PCa (p < .05), the PSA density, PI-RADS score were the independent risk factors of csPCa (p < .05). PI-RADS score threshold of 3 could achieve the highest Yonder index for predicting PCa, and PI-RADS score threshold of 4 could achieve the highest Yonder index for predicting csPCa. Therefore, we draw a conclusion that PI-RADSv2 score-based bpMRI could diminish the unnecessary prostate biopsies in patients with elevated PSA when combined with other PSA-related indicators.
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Affiliation(s)
- Jun Zhu
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhen Liang
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Song
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongjiao Yang
- Urology Department, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yawei Xu
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Lu
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Hu
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Ningjing Ou
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zhang
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoqiang Liu
- Urology Department, Tianjin Medical University General Hospital, Tianjin, China
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Liang Z, Hu R, Yang Y, An N, Duo X, Liu Z, Shi S, Liu X. Is dynamic contrast enhancement still necessary in multiparametric magnetic resonance for diagnosis of prostate cancer: a systematic review and meta-analysis. Transl Androl Urol 2020; 9:553-573. [PMID: 32420161 PMCID: PMC7215029 DOI: 10.21037/tau.2020.02.03] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this study is to systematically review the literatures assessing the value of dynamic contrast enhancement (DCE) in the multiparametric magnetic resonance imaging (mpMRI) for the diagnosis of prostate cancer (PCa). Methods We searched Embase, PubMed and Web of science until January 2019 to extract articles exploring the possibilities whether the pre-biopsy biparametric magnetic resonance imaging (bpMRI) can replace the position of mpMRI in the diagnosis of PCa. The sensitivity and specificity of bpMRI were all included. The study quality was assessed by QUADAS-2. Bivariate random effects meta-analyses and a hierarchical summary receiver operating characteristic plot were performed for further study through Revman 5 and Stata12. Results After searching, we acquired 752 articles among which 45 studies with 5,217 participants were eligible for inclusion. The positive likelihood ratio for the detection of PCa was 2.40 (95% CI: 1.50–3.80) and the negative likelihood ratio was 0.31 (95% CI: 0.18–0.53). The sensitivity and specificity were 0.77 (95% CI: 0.73–0.81) and 0.81 (95% CI: 0.76–0.85) respectively. Based on our result, pooled specificity demonstrated little difference between bpMRI and mpMRI [bpMRI, 0.81 (95% CI, 0.76–0.85); mpMRI, 0.82 (95% CI, 0.72–0.88); P=0.169]. The sensitivity, however, indicated a significant difference between these two groups [bpMRI, 0.77 (95% CI, 0.73–0.81); mpMRI, 0.84 (95% CI, 0.78–0.89); P=0.001]. Conclusions bpMRI with high b-value is a sensitive tool for diagnosing PCa. Consistent results were found in multiple subgroup analysis.
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Affiliation(s)
- Zhen Liang
- Department of Urology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Rui Hu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Yongjiao Yang
- Department of Urology, Tianjin Medical University Second Hospital, Tianjin 300000, China
| | - Neng An
- Department of Urology, Tianjin Medical University Second Hospital, Tianjin 300000, China
| | - Xiaoxin Duo
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Zheng Liu
- Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Shangheng Shi
- Department of Transplantation, Affiliated Hospital of Medical College Qingdao University, Qingdao 266000, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin 300000, China
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Zhen L, Liu X, Yegang C, Yongjiao Y, Yawei X, Jiaqi K, Xianhao W, Yuxuan S, Rui H, Wei Z, Ningjing O. Accuracy of multiparametric magnetic resonance imaging for diagnosing prostate Cancer: a systematic review and meta-analysis. BMC Cancer 2019; 19:1244. [PMID: 31870327 PMCID: PMC6929472 DOI: 10.1186/s12885-019-6434-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 12/04/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The application of multiparametric magnetic resonance imaging (mpMRI) for diagnosis of prostate cancer has been recommended by the European Association of Urology (EAU), National Comprehensive Cancer Network (NCCN), and European Society of Urogenital Radiology (ESUR) guidelines. The purpose of this study is to systematically review the literature on assessing the accuracy of mpMRI in patients with suspicion of prostate cancer. METHOD We searched Embase, Pubmed and Cochrane online databases from January 12,000 to October 272,018 to extract articles exploring the possibilities that the pre-biopsy mpMRI can enhance the diagnosis accuracy of prostate cancer. The numbers of true- and false-negative results and true- and false-positive ones were extracted to calculate the corresponding sensitivity and specificity of mpMRI. Study quality was assessed using QUADAS-2 tool. Random effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) plot were performed for further study. RESULTS After searching, we acquired 3741 articles for reference, of which 29 studies with 8503 participants were eligible for inclusion. MpMRI maintained impressive diagnostic value, the area under the HSROC curve was 0.87 (95%CI,0.84-0.90). The sensitivity and specificity for mpMRI were 0.87 [95%CI, 0.81-0.91] and 0.68 [95%CI,0.56-0.79] respectively. The positive likelihood ratio was 2.73 [95%CI 1.90-3.90]; negative likelihood ratio was 0.19 [95% CI 0.14,-0.27]. The risk of publication bias was negligible with P = 0.96. CONCLUSION Results of the meta-analysis suggest that mpMRI is a sensitive tool to diagnose prostate cancer. However, because of the high heterogeneity existing among the included studies, further studies are needed to apply the results of this meta-analysis in clinic.
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Affiliation(s)
- Liang Zhen
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Chen Yegang
- Department of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yang Yongjiao
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Xu Yawei
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Kang Jiaqi
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Wang Xianhao
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Song Yuxuan
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Hu Rui
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Zhang Wei
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
| | - Ou Ningjing
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300211 People’s Republic of China
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Abstract
DCE MRI is an established component of multi-parametric MRI of the prostate. The sequence highlights the vascularization of cancerous lesions, allowing readers to corroborate suspicious findings on T2W and DW MRI and to note subtle lesions not visible on the other sequences. In this article, we review the technical aspects, methods of evaluation, limitations, and future perspectives of DCE MRI.
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Aydın H, Kızılgöz V, Tekin BO. Overview of current multiparametric magnetic resonance imaging approach in the diagnosis and staging of prostate cancer. Kaohsiung J Med Sci 2015; 31:167-78. [DOI: 10.1016/j.kjms.2015.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 10/07/2014] [Accepted: 02/19/2014] [Indexed: 01/08/2023] Open
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