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01.12.2010 | Urogenital

Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

verfasst von: Daniel Portalez, Gautier Rollin, Pierre Leandri, Benjamin Elman, Patrick Mouly, Frédéric Jonca, Bernard Malavaud

Erschienen in: European Radiology | Ausgabe 12/2010

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Abstract

Objectives

To compare T2-weighted MRI and functional MRI techniques in guiding repeat prostate biopsies.

Methods

Sixty-eight patients with a history of negative biopsies, negative digital rectal examination and elevated PSA were imaged before repeat biopsies. Dichotomous criteria were used with visual validation of T2-weighted MRI, dynamic contrast-enhanced MRI and literature-derived cut-offs for 3D-spectroscopy MRI (choline-creatine-to-citrate ratio >0.86) and diffusion-weighted imaging (ADC × 10³ mm²/s < 1.24). For each segment and MRI technique, results were rendered as being suspicious/non-suspicious for malignancy. Sextant biopsies, transition zone biopsies and at least two additional biopsies of suspicious areas were taken.

Results

In the peripheral zones, 105/408 segments and in the transition zones 19/136 segments were suspicious according to at least one MRI technique. A total of 28/68 (41.2%) patients were found to have cancer. Diffusion-weighted imaging exhibited the highest positive predictive value (0.52) compared with T2-weighted MRI (0.29), dynamic contrast-enhanced MRI (0.33) and 3D-spectroscopy MRI (0.25). Logistic regression showed the probability of cancer in a segment increasing 12-fold when T2-weighted and diffusion-weighted imaging MRI were both suspicious (63.4%) compared with both being non-suspicious (5.2%).

Conclusion

The proposed system of analysis and reporting could prove clinically relevant in the decision whether to repeat targeted biopsies.

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Titel: Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies
verfasst von: Daniel Portalez
Gautier Rollin
Pierre Leandri
Benjamin Elman
Patrick Mouly
Frédéric Jonca
Bernard Malavaud
Publikationsdatum: 01.12.2010
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 12/2010
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1868-6

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Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies