MP03-19 DIFFERENCE BETWEEN THE PZ AND THE TZ IN DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING (MRI) 5-POINT LIKERT SCORING SYSTEM EVALUATED BY THE RESULT OF MRI/ULTRASONOGRAPHY FUSION TARGETED BIOPSY OF THE PROSTATE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I1 Apr 2017MP03-19 DIFFERENCE BETWEEN THE PZ AND THE TZ IN DIAGNOSTIC ACCURACY OF MAGNETIC RESONANCE IMAGING (MRI) 5-POINT LIKERT SCORING SYSTEM EVALUATED BY THE RESULT OF MRI/ULTRASONOGRAPHY FUSION TARGETED BIOPSY OF THE PROSTATE Toshitaka Shin, Thomas Smyth, Osamu Ukimura, Nariman Ahmadi, Andre Luis Abreu, Daniel Freitas, Carlos Fay, Masakatsu Oishi, Hiromitsu Mimata, and Inderbir Gill Toshitaka ShinToshitaka Shin More articles by this author , Thomas SmythThomas Smyth More articles by this author , Osamu UkimuraOsamu Ukimura More articles by this author , Nariman AhmadiNariman Ahmadi More articles by this author , Andre Luis AbreuAndre Luis Abreu More articles by this author , Daniel FreitasDaniel Freitas More articles by this author , Carlos FayCarlos Fay More articles by this author , Masakatsu OishiMasakatsu Oishi More articles by this author , Hiromitsu MimataHiromitsu Mimata More articles by this author , and Inderbir GillInderbir Gill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.136AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) scoring system for prostate cancer detection in the peripheral zone (PZ) and the transition zone (TZ) using MRI/trans-rectal ultrasonography (US) fusion targeted biopsy as a reference standard. METHODS We retrospectively reviewed 762 patients who underwent 3-Tesla multi-parametric (mp)-MRI and the following MRI/US fusion targeted biopsy, all of which were performed by experienced urologists (10/2012-8/2015). We excluded patients in whom MRI did not identify any suspicious lesions and radiologists who reported in less than 50 cases. Finally, 648 patients with 1255 suspicious lesions were included in this study. The mp-MRIs were reported on a 5-point Likert scale of suspicion. The UroStation® (Koelis, France) was used for the image fusion. Clinically significant cancer was defined as biopsy Gleason score ≥7. RESULTS Median age was 64 years, pre-biopsy prostate-specific antigen (PSA) level was 6.93 ng/ml and estimated prostate volume was 52.1 ml. Of 1255 suspicious lesions on MRI, 62.4% (n=783) were located in the PZ and 19.5% (n=245) in the TZ.There was no significant difference in the proportion of 5-point suspicious grades between the PZ and the TZ (p=0.077). In comparison between the PZ and the TZ, there was no significant difference in overall cancer detection rate in grade 1-2 lesions (11.8% vs 15.1%, p=0.362), grade 3 lesions (26.9% vs 19.8%, p=0.163) and grade 4-5 lesions (55.4% vs 50.0%, p=0.551). Regarding clinically significant cancer detection rate, there was no significant difference in grade 1-2 lesions between the PZ and the TZ (3.1% vs 6.6%, p=0.087). In contrast, statistical differences were noted in grade 3 lesions (15.1% vs 5.9%, p=0.019) and grade 4-5 lesions (45.9% vs 23.7%, p=0.013) between the PZ and the TZ. CONCLUSIONS The diagnostic reliability of mp-MRI for detecting clinically significant cancer in the TZ was less than that in the PZ. Although grade 3 lesions in the TZ showed similar overall cancer detection rate compared to that in the PZ, clinically significant cancer detection rate of grade 3 lesions in the TZ was quite lower than that in the PZ. Improvement of radiologist's interpretation, grading system itself, or targeting technique for grade 3 lesions in the TZ should be re-considered. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e27 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Toshitaka Shin More articles by this author Thomas Smyth More articles by this author Osamu Ukimura More articles by this author Nariman Ahmadi More articles by this author Andre Luis Abreu More articles by this author Daniel Freitas More articles by this author Carlos Fay More articles by this author Masakatsu Oishi More articles by this author Hiromitsu Mimata More articles by this author Inderbir Gill More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...