Diffusion-weighted magnetic resonance imaging detects significant prostate cancer with high probability

Bains, Lauren; Studer, Urs; Froehlich, Johannes M; Giannarini, Gianluca; Triantafyllou, Maria; Fleischmann, Achim; Thöny, Harriet C. (2014). Diffusion-weighted magnetic resonance imaging detects significant prostate cancer with high probability. Journal of urology, 192(3), pp. 737-742. Elsevier 10.1016/j.juro.2014.03.039

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PURPOSE We prospectively assessed the diagnostic accuracy of diffusion-weighted magnetic resonance imaging for detecting significant prostate cancer. MATERIALS AND METHODS We performed a prospective study of 111 consecutive men with prostate and/or bladder cancer who underwent 3 Tesla diffusion-weighted magnetic resonance imaging of the pelvis without an endorectal coil before radical prostatectomy (78) or cystoprostatectomy (33). Three independent readers blinded to clinical and pathological data assigned a prostate cancer suspicion grade based on qualitative imaging analysis. Final pathology results of prostates with and without cancer served as the reference standard. Primary outcomes were the sensitivity and specificity of diffusion-weighted magnetic resonance imaging for detecting significant prostate cancer with significance defined as a largest diameter of the index lesion of 1 cm or greater, extraprostatic extension, or Gleason score 7 or greater on final pathology assessment. Secondary outcomes were interreader agreement assessed by the Fleiss κ coefficient and image reading time. RESULTS Of the 111 patients 93 had prostate cancer, which was significant in 80 and insignificant in 13, and 18 had no prostate cancer on final pathology results. The sensitivity and specificity of diffusion-weighted magnetic resonance imaging for detecting significant PCa was 89% to 91% and 77% to 81%, respectively, for the 3 readers. Interreader agreement was good (Fleiss κ 0.65 to 0.74). Median reading time was between 13 and 18 minutes. CONCLUSIONS Diffusion-weighted magnetic resonance imaging (3 Tesla) is a noninvasive technique that allows for the detection of significant prostate cancer with high probability without contrast medium or an endorectal coil, and with good interreader agreement and a short reading time. This technique should be further evaluated as a tool to stratify patients with prostate cancer for individualized treatment options.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Bains, Lauren; Studer, Urs; Giannarini, Gianluca; Triantafyllou, Maria; Fleischmann, Achim and Thöny, Harriet C.

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0022-5347

Publisher:

Elsevier

Language:

English

Submitter:

Katharina Morgenegg

Date Deposited:

26 Feb 2015 16:38

Last Modified:

05 Nov 2015 10:37

Publisher DOI:

10.1016/j.juro.2014.03.039

PubMed ID:

24641913

Uncontrolled Keywords:

prostate, prostatic neoplasms, diagnosis, differential, magnetic resonance imaging, observer variation

BORIS DOI:

10.7892/boris.63487

URI:

https://boris.unibe.ch/id/eprint/63487

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