MP53-05 PERFORMANCE OF 3T MULTIPARAMETERIC MRI IN DIAGNOSIS OF PROSTATE CANCER IN COMPARISON WITH WHOLE MOUNT HISTOPATHOLOGY: A 5 YEAR EXPERIENCE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2016MP53-05 PERFORMANCE OF 3T MULTIPARAMETERIC MRI IN DIAGNOSIS OF PROSTATE CANCER IN COMPARISON WITH WHOLE MOUNT HISTOPATHOLOGY: A 5 YEAR EXPERIENCE pornphan wibulpolprasert, Steven S. Raman, Pooria Khoshnoodi, Weixia Yu, William Hsu, Nelly Tan, Jiaoti Huang, David Lu, Danial J Margolis, and Robert Reiter pornphan wibulpolprasertpornphan wibulpolprasert More articles by this author , Steven S. RamanSteven S. Raman More articles by this author , Pooria KhoshnoodiPooria Khoshnoodi More articles by this author , Weixia YuWeixia Yu More articles by this author , William HsuWilliam Hsu More articles by this author , Nelly TanNelly Tan More articles by this author , Jiaoti HuangJiaoti Huang More articles by this author , David LuDavid Lu More articles by this author , Danial J MargolisDanial J Margolis More articles by this author , and Robert ReiterRobert Reiter More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.502AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) is the most common solid organ malignancy in men. The challenge is to minimize morbidity from overdiagnosis of low grade disease and maximize diagnosis of high grade disease and index lesions > 1 cm which require more aggressive treatment. Multiparametric MRI (MP-MRI) provides a non-invasive, volumetric assessment of the entire prostate combining anatomic T2W with functional and assessment of tumor biology, including diffusion-weighted imaging (DWI) and its derivative apparent-diffusion coefficient (ADC) maps and dynamic contrast-enhanced (DCE) MRI. These parameters are now combined to provide a PI-RADS assessment of individual lesions to determine their aggressiveness. The objective is to determine Prostate Cancer (PCa) detection rate of 3T MP-MRI in 346 consecutive men over 5 years. METHODS A HIPPA compliant, IRB approved study of 346 consecutive patients who underwent multiparametric prostate MRI (MP-MRI) with a PI RADS based scoring system for individual lesions correlated to whole mount histopathology was performed. For each lesion individual MP-MRI parameters were graded on 1-5 scale, with“1”being unsuspicious and“5”as very suspicious of prostate cancer. A genitourinary (GU) radiologist and GU pathologist reviewed each available slice in each case to match each MRI ROI to the concordant foci on whole mount specimen of the prostate gland to serve as truth. Descriptive statistical analysis by frequency and percentage were used for base line characteristic of tumors and tumor detection rate by MP-MRI. RESULTS In this cohort, 346 patients had 457 tumors and 311 tumor index (= 1 cm). Of index tumors, 51.6% of were Gleason 3+4, 23.5 % were Gleason 4+3, 14.2 % were Gleason 8-10. Overall, 10.6% of tumors were Gleason 3+3. The MP-MRI detection rate for overall tumors and index tumors were 67% (306/457) and 83.3% (259/311) respectively. The tumor detection rate for an overall PI RADS score of 5, 4, and 3 were 97.6%, 87.2%, and 67.9% respectively. By component T2, DWI, and DCE scores of 5, 4, and 3 the tumor detection rates were as follows: T2: 93.3%, 87.4 %, and 65.8 %; DWI: 94.9 %, 81.7 %, and 61.3; and DCE: 98.3 %, 77.6%, 79.1%, respectively. The overall MP MRI tumor detection rate for PCa with Gleason score 8-10, 4+3, 3+4, and 3+3 were 88.6 %, 83.6%, 81.2%, and 66.7%, respectively. CONCLUSIONS Mp-MRI combined with a growing interpreter experience has substantially improved diagnostic capabilities for prostate cancer care as well as increasing confidence for tumor detection and grading of individual lesions. The best tumor detection rates were achieved for high Gleason grade index lesions, especially those with PI RADS score of 4 or 5. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e698 Advertisement Copyright & Permissions© 2016MetricsAuthor Information pornphan wibulpolprasert More articles by this author Steven S. Raman More articles by this author Pooria Khoshnoodi More articles by this author Weixia Yu More articles by this author William Hsu More articles by this author Nelly Tan More articles by this author Jiaoti Huang More articles by this author David Lu More articles by this author Danial J Margolis More articles by this author Robert Reiter More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...