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Multiparametric MRI identifies and stratifies prostate cancer lesions: implications for targeting intraprostatic targets.
- Source :
-
Brachytherapy [Brachytherapy] 2014 May-Jun; Vol. 13 (3), pp. 292-8. Date of Electronic Publication: 2014 Apr 05. - Publication Year :
- 2014
-
Abstract
- Purpose: To assess the ability of multiparametric (mp) MRI (mp-MRI) to identify, stratify, and localize biopsy-proven prostate cancer lesions in a risk-stratified patient population.<br />Methods and Materials: We retrospectively analyzed 57 patients who had mp-MRI and core needle biopsy during diagnostic prostate cancer evaluation. The MRI sequences were scored for suspicion of cancer with a previously described system. Distributions of mp-MRI scores were compared across National Comprehensive Cancer Network prostate cancer risk groups. The mp-MRI-identified lesions were compared with the location of positive core needle biopsies to assess mp-MRI localization of true lesions.<br />Results: The mp-MRI scoring system identified lesions in 84% (48/57) of the patients, including 100% (12/12) in the high-risk group. Scores assigned to lesions in patients in intermediate- and high-risk groups were statistically higher than those in the low-risk group, with a relative risk of 6.72 (95% confidence interval: 2.32-19.51, p<0.001) of having an aggressive score assigned in high-risk patients compared with the low-risk patients. In comparing the localization data from core needle biopsy, 68% of the patients had an MRI-identified lesion in or within one adjacent sextant of the same prostate hemigland, including 85% of aggressive lesions.<br />Conclusions: Use of mp-MRI at the time of diagnosis can identify intraprostatic lesions and assign suspicion for high-risk disease. These data show that high-risk patients are more likely to have suspicious imaging-identified lesions that correlate to the location of biopsy-proven prostate cancer. At this time, the use of mp-MRI to define focal targets represents a complementary tool to patient evaluation for focal therapy strategies.<br /> (Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma diagnosis
Adenocarcinoma radiotherapy
Adult
Aged
Humans
Image-Guided Biopsy
Male
Middle Aged
Poisson Distribution
Prostatic Neoplasms diagnosis
Prostatic Neoplasms radiotherapy
Retrospective Studies
Adenocarcinoma pathology
Brachytherapy methods
Magnetic Resonance Imaging methods
Prostatic Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-1449
- Volume :
- 13
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Brachytherapy
- Publication Type :
- Academic Journal
- Accession number :
- 24709516
- Full Text :
- https://doi.org/10.1016/j.brachy.2014.01.011