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Erschienen in: European Radiology 2/2014

01.02.2014 | Urogenital

Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla

verfasst von: M. C. Roethke, T. H. Kuru, S. Schultze, D. Tichy, A. Kopp-Schneider, M. Fenchel, H.-P. Schlemmer, B. A. Hadaschik

Erschienen in: European Radiology | Ausgabe 2/2014

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Abstract

Objectives

To evaluate the Prostate Imaging Reporting and Data System (PI-RADS) proposed by the European Society of Urogenital Radiology (ESUR) for detection of prostate cancer (PCa) by multiparametric magnetic resonance imaging (mpMRI) in a consecutive cohort of patients with magnetic resonance/transrectal ultrasound (MR/TRUS) fusion-guided biopsy.

Methods

Suspicious lesions on mpMRI at 3.0 T were scored according to the PI-RADS system before MR/TRUS fusion-guided biopsy and correlated to histopathology results. Statistical correlation was obtained by a Mann–Whitney U test. Receiver operating characteristics (ROC) and optimal thresholds were calculated.

Results

In 64 patients, 128/445 positive biopsy cores were obtained out of 95 suspicious regions of interest (ROIs). PCa was present in 27/64 (42 %) of the patients. ROC results for the aggregated PI-RADS scores exhibited higher areas under the curve compared to those of the Likert score. Sensitivity/specificity for the following thresholds were calculated: 73 %/92 % and 85 %/67 % for PI-RADS scores of 9 and 10, respectively; 85 %/56 % and 60 %/97 % for Likert scores of 3 and 4, respectively.

Conclusions

The standardised ESUR PI-RADS system is beneficial to indicate the likelihood of PCa of suspicious lesions on mpMRI. It is also valuable to identify locations to be targeted with biopsy. The aggregated PI-RADS score achieved better results compared to the single five-point Likert score.

Key points

The ESUR PI-RADS scoring system was evaluated using multiparametric 3.0-T MRI.
To investigate suspicious findings, transperineal MR/TRUS fusion-guided biopsy was used.
PI-RADS can guide biopsy locations and improve detection of clinically significant cancer.
Biopsy procedures can be optimised, reducing unnecessary negative biopsies for patients.
The PI-RADS scoring system may contribute to more effective prostate MRI.
Literatur
1.
Zurück zum Zitat Ahmed HU, Kirkham A, Arya M et al (2009) Is it time to consider a role for MRI before prostate biopsy? Nat Rev Clin Oncol 6:197–206PubMedCrossRef Ahmed HU, Kirkham A, Arya M et al (2009) Is it time to consider a role for MRI before prostate biopsy? Nat Rev Clin Oncol 6:197–206PubMedCrossRef
2.
Zurück zum Zitat Heidenreich A, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71PubMedCrossRef Heidenreich A, Bellmunt J, Bolla M et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71PubMedCrossRef
3.
Zurück zum Zitat Kirkham AP, Emberton M, Allen C (2006) How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 50:1163–1174PubMedCrossRef Kirkham AP, Emberton M, Allen C (2006) How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 50:1163–1174PubMedCrossRef
4.
Zurück zum Zitat Dickinson L, Ahmed HU, Allen C et al (2011) Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 59:477–494PubMedCrossRef Dickinson L, Ahmed HU, Allen C et al (2011) Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 59:477–494PubMedCrossRef
5.
Zurück zum Zitat Hoeks CM, Barentsz JO, Hambrock T et al (2011) Prostate cancer: multiparametric MR imaging for detection, localization, and staging. Radiology 261:46–66PubMedCrossRef Hoeks CM, Barentsz JO, Hambrock T et al (2011) Prostate cancer: multiparametric MR imaging for detection, localization, and staging. Radiology 261:46–66PubMedCrossRef
6.
Zurück zum Zitat Dickinson L, Ahmed HU, Allen C et al (2013) Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: could standardization lead to improved utilization of imaging within the diagnostic pathway? J Magn Reson Imaging 37:48–58PubMedCrossRef Dickinson L, Ahmed HU, Allen C et al (2013) Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: could standardization lead to improved utilization of imaging within the diagnostic pathway? J Magn Reson Imaging 37:48–58PubMedCrossRef
8.
Zurück zum Zitat Molleran V, Mahoney MC (2010) The BI-RADS breast magnetic resonance imaging lexicon. Magn Reson Imaging Clin N Am 18:171–185PubMedCrossRef Molleran V, Mahoney MC (2010) The BI-RADS breast magnetic resonance imaging lexicon. Magn Reson Imaging Clin N Am 18:171–185PubMedCrossRef
9.
Zurück zum Zitat Portalez D, Rollin G, Leandri P et al (2010) Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies. Eur Radiol 20:2781–2790PubMedCrossRef Portalez D, Rollin G, Leandri P et al (2010) Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies. Eur Radiol 20:2781–2790PubMedCrossRef
10.
Zurück zum Zitat Schimmöller L, Quentin M, Arsov C et al (2013) Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard. Eur Radiol. doi:10.1007/s00330-013-2922-y Schimmöller L, Quentin M, Arsov C et al (2013) Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard. Eur Radiol. doi:10.​1007/​s00330-013-2922-y
11.
Zurück zum Zitat Roethke M, Blondin D, Schlemmer HP, Franiel T (2013) PI-RADS classification: structured reporting for MRI of the prostate. Rofo 185:253–261CrossRef Roethke M, Blondin D, Schlemmer HP, Franiel T (2013) PI-RADS classification: structured reporting for MRI of the prostate. Rofo 185:253–261CrossRef
12.
Zurück zum Zitat Hadaschik BA, Kuru TH, Tulea C et al (2011) A novel stereotactic prostate biopsy system integrating pre-interventional magnetic resonance imaging and live ultrasound fusion. J Urol 186:2214–2220PubMedCrossRef Hadaschik BA, Kuru TH, Tulea C et al (2011) A novel stereotactic prostate biopsy system integrating pre-interventional magnetic resonance imaging and live ultrasound fusion. J Urol 186:2214–2220PubMedCrossRef
13.
Zurück zum Zitat Kuru TH, Roethke M, Popeneciu V et al (2012) Phantom study of a novel stereotactic prostate biopsy system integrating preinterventional magnetic resonance imaging and live ultrasonography fusion. J Endourol 26:807–813PubMedCrossRef Kuru TH, Roethke M, Popeneciu V et al (2012) Phantom study of a novel stereotactic prostate biopsy system integrating preinterventional magnetic resonance imaging and live ultrasonography fusion. J Endourol 26:807–813PubMedCrossRef
14.
Zurück zum Zitat Vargas HA, Akin O, Shukla-Dave A et al (2012) Performance characteristics of MR imaging in the evaluation of clinically low-risk prostate cancer: a prospective study. Radiology 265:478–487PubMedCrossRef Vargas HA, Akin O, Shukla-Dave A et al (2012) Performance characteristics of MR imaging in the evaluation of clinically low-risk prostate cancer: a prospective study. Radiology 265:478–487PubMedCrossRef
15.
Zurück zum Zitat Weinreb JC, Blume JD, Coakley FV et al (2009) Prostate cancer: sextant localization at MR imaging and MR spectroscopic imaging before prostatectomy–results of ACRIN prospective multi-institutional clinicopathologic study. Radiology 251:122–133PubMedCrossRef Weinreb JC, Blume JD, Coakley FV et al (2009) Prostate cancer: sextant localization at MR imaging and MR spectroscopic imaging before prostatectomy–results of ACRIN prospective multi-institutional clinicopathologic study. Radiology 251:122–133PubMedCrossRef
16.
Zurück zum Zitat Futterer JJ, Engelbrecht MR, Jager GJ et al (2007) Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal-pelvic phased-array coils. Local staging accuracy of prostate cancer using endorectal coil MR imaging. Eur Radiol 17:1055–1065PubMedCrossRef Futterer JJ, Engelbrecht MR, Jager GJ et al (2007) Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal-pelvic phased-array coils. Local staging accuracy of prostate cancer using endorectal coil MR imaging. Eur Radiol 17:1055–1065PubMedCrossRef
17.
Zurück zum Zitat Lee SH, Park KK, Choi KH et al (2010) Is endorectal coil necessary for the staging of clinically localized prostate cancer? Comparison of non-endorectal versus endorectal MR imaging. World J Urol 28:667–672PubMedCrossRef Lee SH, Park KK, Choi KH et al (2010) Is endorectal coil necessary for the staging of clinically localized prostate cancer? Comparison of non-endorectal versus endorectal MR imaging. World J Urol 28:667–672PubMedCrossRef
18.
Zurück zum Zitat Park BK, Kim B, Kim CK, Lee HM, Kwon GY (2007) Comparison of phased-array 3.0-T and endorectal 1.5-T magnetic resonance imaging in the evaluation of local staging accuracy for prostate cancer. J Comput Assist Tomogr 31:534–538PubMedCrossRef Park BK, Kim B, Kim CK, Lee HM, Kwon GY (2007) Comparison of phased-array 3.0-T and endorectal 1.5-T magnetic resonance imaging in the evaluation of local staging accuracy for prostate cancer. J Comput Assist Tomogr 31:534–538PubMedCrossRef
19.
Zurück zum Zitat Scheenen TW, Heijmink SW, Roell SA et al (2007) Three-dimensional proton MR spectroscopy of human prostate at 3 T without endorectal coil: feasibility. Radiology 245:507–516PubMedCrossRef Scheenen TW, Heijmink SW, Roell SA et al (2007) Three-dimensional proton MR spectroscopy of human prostate at 3 T without endorectal coil: feasibility. Radiology 245:507–516PubMedCrossRef
20.
Zurück zum Zitat Klotz L (2012) Active surveillance for favorable-risk prostate cancer: background, patient selection, triggers for intervention, and outcomes. Curr Urol Rep 13:153–159PubMedCrossRef Klotz L (2012) Active surveillance for favorable-risk prostate cancer: background, patient selection, triggers for intervention, and outcomes. Curr Urol Rep 13:153–159PubMedCrossRef
21.
Zurück zum Zitat Rosenkrantz AB, Kim S, Lim RP et al (2013) Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales. Radiology. doi:10.1148/radiol.13122233 Rosenkrantz AB, Kim S, Lim RP et al (2013) Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales. Radiology. doi:10.​1148/​radiol.​13122233
22.
Zurück zum Zitat Harnden P, Naylor B, Shelley MD, Clements H, Coles B, Mason MD (2008) The clinical management of patients with a small volume of prostatic cancer on biopsy: what are the risks of progression? A systematic review and meta-analysis. Cancer 112:971–981PubMedCrossRef Harnden P, Naylor B, Shelley MD, Clements H, Coles B, Mason MD (2008) The clinical management of patients with a small volume of prostatic cancer on biopsy: what are the risks of progression? A systematic review and meta-analysis. Cancer 112:971–981PubMedCrossRef
23.
Zurück zum Zitat Ahmed HU, Hu Y, Carter T et al (2011) Characterizing clinically significant prostate cancer using template prostate mapping biopsy. J Urol 186:458–464PubMedCrossRef Ahmed HU, Hu Y, Carter T et al (2011) Characterizing clinically significant prostate cancer using template prostate mapping biopsy. J Urol 186:458–464PubMedCrossRef
24.
Zurück zum Zitat Roethke M, Anastasiadis AG, Lichy M et al (2012) MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy. World J Urol 30:213–218PubMedCrossRef Roethke M, Anastasiadis AG, Lichy M et al (2012) MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy. World J Urol 30:213–218PubMedCrossRef
25.
Zurück zum Zitat Vargas HA, Akin O, Afaq A et al (2012) Magnetic resonance imaging for predicting prostate biopsy findings in patients considered for active surveillance of clinically low risk prostate cancer. J Urol 188:1732–173826PubMedCrossRef Vargas HA, Akin O, Afaq A et al (2012) Magnetic resonance imaging for predicting prostate biopsy findings in patients considered for active surveillance of clinically low risk prostate cancer. J Urol 188:1732–173826PubMedCrossRef
26.
Zurück zum Zitat Anastasiadis AG, Lichy MP, Nagele U et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50:738–748PubMedCrossRef Anastasiadis AG, Lichy MP, Nagele U et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50:738–748PubMedCrossRef
27.
Zurück zum Zitat Pinto PA, Chung PH, Rastinehad AR et al (2011) Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. J Urol 186:1281–1285PubMedCentralPubMedCrossRef Pinto PA, Chung PH, Rastinehad AR et al (2011) Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. J Urol 186:1281–1285PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Ukimura O, Desai MM, Palmer S et al (2012) 3-Dimensional elastic registration system of prostate biopsy location by real-time 3-dimensional transrectal ultrasound guidance with magnetic resonance/transrectal ultrasound image fusion. J Urol 187:1080–1086PubMedCrossRef Ukimura O, Desai MM, Palmer S et al (2012) 3-Dimensional elastic registration system of prostate biopsy location by real-time 3-dimensional transrectal ultrasound guidance with magnetic resonance/transrectal ultrasound image fusion. J Urol 187:1080–1086PubMedCrossRef
29.
Zurück zum Zitat Baumann M, Mozer P, Daanen V, Troccaz J (2012) Prostate biopsy tracking with deformation estimation. Med Image Anal 16:562–576PubMedCrossRef Baumann M, Mozer P, Daanen V, Troccaz J (2012) Prostate biopsy tracking with deformation estimation. Med Image Anal 16:562–576PubMedCrossRef
30.
Zurück zum Zitat Kasivisvanathan V, Dufour R, Moore CM et al (2013) Transperineal magnetic resonance image targeted prostate biopsy versus transperineal template prostate biopsy in the detection of clinically significant prostate cancer. J Urol 189:860–866PubMedCrossRef Kasivisvanathan V, Dufour R, Moore CM et al (2013) Transperineal magnetic resonance image targeted prostate biopsy versus transperineal template prostate biopsy in the detection of clinically significant prostate cancer. J Urol 189:860–866PubMedCrossRef
Metadaten
Titel
Evaluation of the ESUR PI-RADS scoring system for multiparametric MRI of the prostate with targeted MR/TRUS fusion-guided biopsy at 3.0 Tesla
verfasst von
M. C. Roethke
T. H. Kuru
S. Schultze
D. Tichy
A. Kopp-Schneider
M. Fenchel
H.-P. Schlemmer
B. A. Hadaschik
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-3017-5

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