Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population

摘要

ObjectiveTo evaluate the efficacy of multiparametric magnetic resonance imaging (mp-MRI) using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) definitions in detecting organ-confined prostate cancer.MethodsAll patients who underwent radical prostatectomy between January 1, 2014 and December 30, 2014 were identified. All underwent mp-MRI within 180 days before surgery. Those with prior pelvic irradiation or androgen deprivation therapy were excluded. Fully embedded, whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location, Gleason score (GS) and stage.ResultsThere were 39 patients included, of which 35 (90%) had mp-MRI done post-biopsy. A total of 93 cancer foci were identified on whole-mount pathology, of which mp-MRI detected 63 (68%). Of those detected by mp-MRI, 14 were PI-RADS 3 (n?=?6?for GS 6,n?=?8?for GS 7, no GS?≥?8) and 49 were PI-RADS 4–5 (n?=?7?for GS 6,n?=?33?for GS 7, andn?=?9?for GS?≥?8). There were 30 (32%) cancer foci missed by mp-MRI (n?=?15?for GS 6,n?=?13?for GS 7 andn?=?2?for GS?≥?8). A lesion classified as PI-RADS 4–5 predicted a higher grade cancer on pathology as compared to PI-RADS 3 (for GS 7 lesions, odds ratio [OR]?=?3.53, 95% CI: 0.93–13.45,p?=?0.064). The mp-MRI size detection limit was 20?mm2and 100?mm2for 50% and 75% probability of cancer, respectively. In associating with radiological and pathologic stage, the weighted Kappa value was 0.69 (p?