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Verfasst von:Bonekamp, David [VerfasserIn]   i
 Kuder, Tristan Anselm [VerfasserIn]   i
 Stenzinger, Albrecht [VerfasserIn]   i
 Nyarangi-Dix, Joanne [VerfasserIn]   i
 Röthke, Matthias C. [VerfasserIn]   i
 Hohenfellner, Markus [VerfasserIn]   i
 Schlemmer, Heinz-Peter [VerfasserIn]   i
 Radtke, Jan Philipp [VerfasserIn]   i
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

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