Korean J Urol.  2011 Aug;52(8):572-577. 10.4111/kju.2011.52.8.572.

The Clinical Value of Performing an MRI before Prostate Biopsy

Affiliations
  • 1Department of Urology, The Catholic University of Korea, College of Medicine, Seoul, Korea. ksw1227@catholic.ac.kr

Abstract

PURPOSE
Prostate cancer foci have a characteristic feature in magnetic resonance imaging (MRI). We aimed to assess the clinical value of MRI before prostate biopsy in prostate cancer detection.
MATERIALS AND METHODS
From March 2009 to June 2010, 154 patients were enrolled in this study. A total of 51 patients with a clinical suspicion of prostate cancer underwent prostate MRI by a 3T scanner before transrectal ultrasound (TRUS)-guided biopsies. A total of 103 patients with a clinical suspicion of prostate cancer underwent prostate MRI after biopsies. The sensitivity, specificity, and positive predictive value (PPV) were evaluated. In addition, tumor location of pathologic findings and ADC mapping on MRI were matched and compared.
RESULTS
The sensitivity of MRI before and after biopsy was 84.8% and 92.4%, respectively. The PPV of MRI before and after biopsy was 75.7% and 92.4%, respectively. The MRI location match percentage before and after biopsy was 89.3% and 94.1%, respectively.
CONCLUSIONS
Compared with other previous reports, our results show that the prostate cancer detection sensitivity of MRI is on the rise. Furthermore, MRI before prostate biopsy can provide more information by which to identify prostate cancer during prostate biopsy and thus reduce the false-negative rate.

Keyword

Biopsy; MRI; Prostate cancer

MeSH Terms

Biopsy
Humans
Magnetic Resonance Imaging
Prostate
Prostatic Neoplasms
Sensitivity and Specificity

Figure

  • FIG. 1 Study design and schematic flow of group 1.

  • FIG. 2 Study design and schematic flow of group 2.

  • FIG. 3 (A) A 74-year-old male with prostate cancer. The PSA level was 7.3 ng/ml, GS was 7. The radical prostatectomy specimen showed one clear cancer foci. (B) The MRI images show a focal, round, low signal intensity area in the left peripheral zone.


Reference

1. Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C. Leveling of prostate cancer mortality in Western Europe. Prostate. 2004. 60:46–52.
2. Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist. 2007. 12:20–37.
3. Horndalsveen Berild G, Nielsen K. Accuracy in Core Biopsy of the Prostate. An autopsy study. Urol Int. 1986. 41:276–278.
4. Loch T, Eppelmann U, Lehmann J, Wullich B, Loch A, Stockle M. Transrectal ultrasound guided biopsy of the prostate: random sextant versus biopsies of sono-morphologically suspicious lesions. World J Urol. 2004. 22:357–360.
5. Wefer AE, Hricak H, Vigneron DB, Coakley FV, Lu Y, Wefer J, et al. Sextant localization of prostate cancer: comparison of sextant biopsy, magnetic resonance imaging and magnetic resonance spectroscopic imaging with step section histology. J Urol. 2000. 164:400–404.
6. Hricak H, Choyke PL, Eberhardt SC, Leibel SA, Scardino PT. Imaging prostate cancer: a multidisciplinary perspective. Radiology. 2007. 243:28–53.
7. White S, Hricak H, Forstner R, Kurhanewicz J, Vigneron DB, Zaloudek CJ, et al. Prostate cancer: effect of postbiopsy hemorrhage on interpretation of MR images. Radiology. 1995. 195:385–390.
8. Chelsky M, Schnall MD, Seidmon EJ, Pollack H. Use of endorectal surface coil magnetic resonance imaging for local staging of prostate cancer. J Urol. 1993. 150:391–395.
9. Schnall MD, Imai Y, Tomaszewski J, Pollack HM, Lenkinski RE, Kressel HY. Prostate cancer: local staging with endorectal surface coil MR imaging. Radiology. 1991. 178:797–802.
10. Costouros NG, Coakley FV, Westphalen AC, Qayyum A, Yeh BM, Joe BN, et al. Diagnosis of prostate cancer in patients with an elevated prostate-specific antigen level: role of endorectal MRI and MR spectroscopic imaging. AJR Am J Roentgenol. 2007. 188:812–816.
11. Reinsberg SA, Payne GS, Riches SF, Ashley S, Brewster JM, Morgan VA, et al. Combined use of diffusion-weighted MRI and 1H MR spectroscopy to increase accuracy in prostate cancer detection. AJR Am J Roentgenol. 2007. 188:91–98.
12. Kozlowski P, Chang SD, Jones EC, Berean KW, Chen H, Goldenberg SL. Combined diffusion-weighted and dynamic contrast-enhanced MRI for prostate cancer diagnosis--correlation with biopsy and histopathology. J Magn Reson Imaging. 2006. 24:108–113.
13. Tanimoto A, Nakashima J, Kohno H, Shinmoto H, Kuribayashi S. Prostate cancer screening: the clinical value of diffusion-weighted imaging and dynamic MR imaging in combination with T2-weighted imaging. J Magn Reson Imaging. 2007. 25:146–152.
14. Desouza NM, Reinsberg SA, Scurr ED, Brewster JM, Payne GS. Magnetic resonance imaging in prostate cancer: the value of apparent diffusion coefficients for identifying malignant nodules. Br J Radiol. 2007. 80:90–95.
15. Shimofusa R, Fujimoto H, Akamata H, Motoori K, Yamamoto S, Ueda T, et al. Diffusion-weighted imaging of prostate cancer. J Comput Assist Tomogr. 2005. 29:149–153.
16. Morgan VA, Kyriazi S, Ashley SE, DeSouza NM. Evaluation of the potential of diffusion-weighted imaging in prostate cancer detection. Acta Radiol. 2007. 48:695–703.
17. Haider MA, van der Kwast TH, Tanguay J, Evans AJ, Hashmi AT, Lockwood G, et al. Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. AJR Am J Roentgenol. 2007. 189:323–328.
18. Aus G, Bergdahl S, Lodding P, Lilja H, Hugosson J. Prostate cancer screening decreases the absolute risk of being diagnosed with advanced prostate cancer--results from a prospective, population-based randomized controlled trial. Eur Urol. 2007. 51:659–664.
19. Oberaigner W, Horninger W, Klocker H, Schönitzer D, Stühlinger W, Bartsch G. Reduction of prostate cancer mortality in Tyrol, Austria, after introduction of prostate-specific antigen testing. Am J Epidemiol. 2006. 164:376–384.
20. Lemaitre L, Puech P, Poncelet E, Bouyé S, Leroy X, Biserte J, et al. Dynamic contrast-enhanced MRI of anterior prostate cancer: morphometric assessment and correlation with radical prostatectomy findings. Eur Radiol. 2009. 19:470–480.
21. Bouyé S, Potiron E, Puech P, Leroy X, Lemaitre L, Villers A. Transition zone and anterior stromal prostate cancers: zone of origin and intraprostatic patterns of spread at histopathology. Prostate. 2009. 69:105–113.
22. Haffner J, Lemaitre L, Puech P, Haber GP, Leroy X, Jones JS, et al. Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging targeted and systematic biopsy for significant prostate cancer detection. BJU Int. 2011. 22:doi: 10.1111/j.1464-410X.2011.10112.x.
23. Rietbergen JB, Kruger AE, Hoedemaeker RF, Bangma CH, Kirkels MJ, Schröder FH. Repeat screening for prostate cancer after 1-year followup in 984 biopsied men: clinical and pathological features of detected cancer. J Urol. 1998. 160:2121–2125.
24. Ellis WJ, Brawer MK. Repeat prostate needle biopsy: who needs it? J Urol. 1995. 153:1496–1498.
25. Keetch D, Catalona W, Smith DS. Serial prostatic biopsies in men with persistently elevated serum prostate specific antigen values. J Urol. 1994. 151:1571–1574.
26. Woodrum DL, Brawer MK, Partin AW, Catalona WJ, Southwick PC. Interpretation of free prostate specific antigen clinical research studies for the detection of prostate cancer. J Urol. 1998. 159:5–12.
27. Catalona WJ, Partin AW, Slawin KM, Brawer MK, Flanigan RC, Patel A, et al. Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA. 1998. 279:1542–1547.
28. Scattoni V, Zlotta A, Montironi R, Schulman C, Rigatti P, Montorsi F. Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. Eur Urol. 2007. 52:1309–1322.
29. Shimizu T, Nishie A, Ro T, Tajima T, Yamaguchi A, Kono S, et al. Prostate cancer detection: the value of performing an MRI before a biopsy. Acta Radiol. 2009. 50:1080–1088.
30. Park SY, Kim JJ, Kim TH, Lim SH, Han DH, Park BK, et al. The role of endorectal magnetic resonance imaging in predicting extraprostatic extension and Seminal vesicle invasion in clinically localized prostate cancer. Korean J Urol. 2010. 51:308.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr