The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting

Abstract Objectives To investigate the utility of Magnetic Resonance Imaging (MRI) for prostate cancer diagnosis in the Australian setting. Patients and methods All consecutive men who underwent a prostate biopsy (transperineal or transrectal) at Royal Melbourne Hospital between July 2017 to June 20...

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Autores principales:	Jia Ying Isaac Tay, Ken Chow, Dominic J. Gavin, Evie Mertens, Nicholas Howard, Benjamin Thomas, Philip Dundee, Justin Peters, Paul Simkin, Sevastjan Kranz, Moira Finlay, Stefan Heinze, Brian Kelly, Anthony Costello, Niall Corcoran
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	active surveillance biopsy ERSPC risk calculator multiparametric magenetic resonance imaging prostate Cancer Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/519f9937f34745d186c7d520637b9597
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spelling	oai:doaj.org-article:519f9937f34745d186c7d520637b95972021-11-17T16:19:36ZThe utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting2688-452610.1002/bco2.99https://doaj.org/article/519f9937f34745d186c7d520637b95972021-11-01T00:00:00Zhttps://doi.org/10.1002/bco2.99https://doaj.org/toc/2688-4526Abstract Objectives To investigate the utility of Magnetic Resonance Imaging (MRI) for prostate cancer diagnosis in the Australian setting. Patients and methods All consecutive men who underwent a prostate biopsy (transperineal or transrectal) at Royal Melbourne Hospital between July 2017 to June 2019 were included, totalling 332 patients. Data were retrospectively collected from patient records. For each individual patient, the risk of prostate cancer diagnosis at biopsy based on clinical findings was determined using the European Randomized study of Screening for Prostate Cancer (ERSPC) risk calculator, with and without incorporation of MRI findings. Results MRI has good diagnostic accuracy for clinically significant prostate cancer. A PI‐RADS 2 or lower finding has a negative predictive value of 96% for clinically significant cancer, and a PI‐RADS 3, 4 or 5 MRI scan has a sensitivity of 93%. However, MRI has a false negative rate of 6.5% overall for clinically significant prostate cancers. Pre‐ biopsy MRI may reduce the number of unnecessary biopsies, as up to 50.0% of negative or ISUP1 biopsies have MRI PI‐RADS 2 or lower. Incorporation of MRI findings into the ERSPC calculator improved predictive performance for all prostate cancer diagnoses (AUC 0.77 vs 0.71, P = .04), but not for clinically significant cancer (AUC 0.89 vs 0.87, P = .37). Conclusion MRI has good sensitivity and negative predictive value for clinically significant prostate cancers. It is useful as a pre‐biopsy tool and can be used to significantly reduce the number of unnecessary prostate biopsies. However, MRI does not significantly improve risk predictions for clinically significant cancers when incorporated into the ERSPC risk calculator.Jia Ying Isaac TayKen ChowDominic J. GavinEvie MertensNicholas HowardBenjamin ThomasPhilip DundeeJustin PetersPaul SimkinSevastjan KranzMoira FinlayStefan HeinzeBrian KellyAnthony CostelloNiall CorcoranWileyarticleactive surveillancebiopsyERSPC risk calculatormultiparametric magenetic resonance imagingprostate CancerDiseases of the genitourinary system. UrologyRC870-923ENBJUI Compass, Vol 2, Iss 6, Pp 377-384 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	active surveillance biopsy ERSPC risk calculator multiparametric magenetic resonance imaging prostate Cancer Diseases of the genitourinary system. Urology RC870-923
spellingShingle	active surveillance biopsy ERSPC risk calculator multiparametric magenetic resonance imaging prostate Cancer Diseases of the genitourinary system. Urology RC870-923 Jia Ying Isaac Tay Ken Chow Dominic J. Gavin Evie Mertens Nicholas Howard Benjamin Thomas Philip Dundee Justin Peters Paul Simkin Sevastjan Kranz Moira Finlay Stefan Heinze Brian Kelly Anthony Costello Niall Corcoran The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
description	Abstract Objectives To investigate the utility of Magnetic Resonance Imaging (MRI) for prostate cancer diagnosis in the Australian setting. Patients and methods All consecutive men who underwent a prostate biopsy (transperineal or transrectal) at Royal Melbourne Hospital between July 2017 to June 2019 were included, totalling 332 patients. Data were retrospectively collected from patient records. For each individual patient, the risk of prostate cancer diagnosis at biopsy based on clinical findings was determined using the European Randomized study of Screening for Prostate Cancer (ERSPC) risk calculator, with and without incorporation of MRI findings. Results MRI has good diagnostic accuracy for clinically significant prostate cancer. A PI‐RADS 2 or lower finding has a negative predictive value of 96% for clinically significant cancer, and a PI‐RADS 3, 4 or 5 MRI scan has a sensitivity of 93%. However, MRI has a false negative rate of 6.5% overall for clinically significant prostate cancers. Pre‐ biopsy MRI may reduce the number of unnecessary biopsies, as up to 50.0% of negative or ISUP1 biopsies have MRI PI‐RADS 2 or lower. Incorporation of MRI findings into the ERSPC calculator improved predictive performance for all prostate cancer diagnoses (AUC 0.77 vs 0.71, P = .04), but not for clinically significant cancer (AUC 0.89 vs 0.87, P = .37). Conclusion MRI has good sensitivity and negative predictive value for clinically significant prostate cancers. It is useful as a pre‐biopsy tool and can be used to significantly reduce the number of unnecessary prostate biopsies. However, MRI does not significantly improve risk predictions for clinically significant cancers when incorporated into the ERSPC risk calculator.
format	article
author	Jia Ying Isaac Tay Ken Chow Dominic J. Gavin Evie Mertens Nicholas Howard Benjamin Thomas Philip Dundee Justin Peters Paul Simkin Sevastjan Kranz Moira Finlay Stefan Heinze Brian Kelly Anthony Costello Niall Corcoran
author_facet	Jia Ying Isaac Tay Ken Chow Dominic J. Gavin Evie Mertens Nicholas Howard Benjamin Thomas Philip Dundee Justin Peters Paul Simkin Sevastjan Kranz Moira Finlay Stefan Heinze Brian Kelly Anthony Costello Niall Corcoran
author_sort	Jia Ying Isaac Tay
title	The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
title_short	The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
title_full	The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
title_fullStr	The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
title_full_unstemmed	The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting
title_sort	utility of magnetic resonance imaging in prostate cancer diagnosis in the australian setting
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/519f9937f34745d186c7d520637b9597
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The utility of magnetic resonance imaging in prostate cancer diagnosis in the Australian setting

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