| Online-Ressource |
Verfasst von: | Bonekamp, David [VerfasserIn]  |
| Kuder, Tristan Anselm [VerfasserIn]  |
| Stenzinger, Albrecht [VerfasserIn]  |
| Nyarangi-Dix, Joanne [VerfasserIn]  |
| Röthke, Matthias C. [VerfasserIn]  |
| Hohenfellner, Markus [VerfasserIn]  |
| Schlemmer, Heinz-Peter [VerfasserIn]  |
| Radtke, Jan Philipp [VerfasserIn]  |
Titel: | Histopathological to multiparametric MRI spatial mapping of extended systematic sextant and MR/TRUS-fusion-targeted biopsy of the prostate |
Verf.angabe: | David Bonekamp, Patrick Schelb, Manuel Wiesenfarth, Tristan Anselm Kuder, Fenja Deister, Albrecht Stenzinger, Joanne Nyarangi-Dix, Matthias Röthke, Markus Hohenfellner, Heinz-Peter Schlemmer, Jan Philipp Radtke |
Jahr: | 2019 |
Jahr des Originals: | 2018 |
Umfang: | 11 S. |
Fussnoten: | Published online: 16 October 2018 ; Gesehen am 17.05.2019 |
Titel Quelle: | Enthalten in: European radiology |
Ort Quelle: | Berlin : Springer, 1991 |
Jahr Quelle: | 2019 |
Band/Heft Quelle: | 29(2019), 4, Seite 1820-1830 |
ISSN Quelle: | 1432-1084 |
| 1613-3757 |
Abstract: | Purpose MRI has limited ability to detect multifocal disease or the full extent of prostate involvement with clinically significant prostate cancer (sPC). We compare the spatial co-localization at sextant resolution of MRI lesions and histopathological mapping by combined targeted and extended systematic biopsies. Materials and methods Sextants were mapped for sPC (ISUP group ≥ 2) by 24-core transperineal systematic biopsies in 316 patients with suspicion for sPC and by MR lesions of PI-RADS score of ≥ 3. The gold standard is combined systematic (median 23 cores) and targeted biopsies.ResultsOf 316 men, 121 (38%) harbored sPC. Of these 121 patients, 4 (3%) had a negative MRI. MRI correctly identified 117/121 (97%) patients with sPC. In these patients, mpMRI missed no additional sPC in 96 (82%), while MRI-negative sPC lesions were present in 21 patients (18%). Of 1896 sextants, 379 (20%) harbored sPC. MR-positive sextants contained sPC in 26% (337/1275), compared to 7% (42/621) in MR-negative sextants. On a patient basis, sensitivity was 0.97, specificity 0.22, positive predictive value 0.43, and negative predictive value 0.91. On a sextant basis, sensitivity was 0.73, specificity 0.38, positive predictive value 0.26, and negative predictive value 0.93.Conclusion MpMRI mapping agreed well with histopathology with, at the observed sPC prevalence and on a patient basis, excellent sensitivity and negative predictive value, and acceptable specificity and positive predictive value for sPC. However, 18% of sPC was outside the mpMRI mapped region, quantifying limitations of MRI for complete localization of disease extent.Key Points • Currently, exclusive MRI mapping of the prostate for focal treatment planning cannot be recommended, as significant prostate cancer may remain untreated in a substantial number of cases. • At the observed sPC prevalence and on a patient basis, mpMRI has excellent sensitivity and NPV, and acceptable specificity and PPV for detection of prostate cancer, supporting its use to detect suspicious lesions before biopsy. • Despite the excellent global performance, 18% of sPC was outside the mpMRI mapped region even when a security margin of 10 mm was considered, indicating that prostate MRI has limited ability to completely map all cancer foci within the prostate. |
DOI: | doi:10.1007/s00330-018-5751-1 |
URL: | Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.
Volltext: https://doi.org/10.1007/s00330-018-5751-1 |
| Volltext: https://doi.org/10.1007/s00330-018-5751-1 |
| DOI: https://doi.org/10.1007/s00330-018-5751-1 |
Datenträger: | Online-Ressource |
Sprache: | eng |
Sach-SW: | Image-guided biopsy |
| Magnetic resonance imaging |
| Male |
| Prostate cancer |
K10plus-PPN: | 1665859237 |
Verknüpfungen: | → Zeitschrift |
Histopathological to multiparametric MRI spatial mapping of extended systematic sextant and MR/TRUS-fusion-targeted biopsy of the prostate / Bonekamp, David [VerfasserIn]; 2019 (Online-Ressource)