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What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?

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De Visschere, Pieter Julien Luc Naesens, Leslie Libbrecht, Louis [UCL] Van Praet, Charles Lumen, Nicolaas Villeirs, Geert

OBJECTIVE: To analyse the characteristics of prostate cancers (PrCa) detected following negative multiparametric magnetic resonance imaging (mpMRI). MATERIALS AND METHODS: Eight hundred and thirty patients with elevated prostate-specific antigen (mean 11.9 μg/l) underwent mpMRI of the prostate at 1.5 Tesla with endorectal coil. The characteristics of all PrCa detected within 2 years after a negative mpMRI were analysed. Primary Gleason grade 4 or any grade 5 PrCa were considered high-grade (HG), Gleason score 3 + 4 intermediate grade (IG) and Gleason score ≤3 + 3 low-grade (LG). Tumour size was considered 'small' when <1 cm on radical prostatectomy specimen or limited to ≤2 cores on prostate biopsy. RESULTS: mpMRI was negative in 391 patients (47.1 %). In 124 patients (31.7 %) PrCa was detected within 2 years. Eighty-four (67.7 %) were LG, 22 (17.7 %) IG and 18 (14.5 %) HG. 119 (96.0 %) of the missed PrCa were organ-confined. The negative predictive value was 95.4 % (373/391) for HG PrCa. Among the 18 missed HG PrCa, 15 (83.3 %) were organ-confined and 12 (66.6 %) were small. CONCLUSION: The majority of missed tumours on mpMRI were low grade and organ-confined. In patients with elevated PSA and a negative mpMRI, consideration could be given to continued surveillance rather than immediate biopsy. KEY POINTS: • The majority of missed prostate cancers were low grade and organ-confined. • In patients with a negative mpMRI a biopsy may be postponed. • mpMRI had a negative predictive value of 95.4 % for high-grade prostate cancer.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2016
Language Anglais
Journal information "European Radiology : journal of the European Congress of Radiology" - Vol. 26, no.4, p. 1098-1107 (2016)
Peer reviewed yes
Publisher Springer ((Germany) Berlin)
issn 0938-7994
e-issn 1432-1084
Publication status Publié
Affiliations UCL - SSS/IREC/SLUC - Pôle St.-Luc
UCL - (SLuc) Service d'anatomie pathologique
MESH Subject Adult ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Reproducibility of Results ; Aged ; Aged, 80 and over ; Biopsy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Grading
Keywords Diffusion magnetic resonance imaging ; Magnetic resonance imaging ; Magnetic resonance spectroscopy ; Prostate ; Prostatic neoplasms
Links
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Bibliographic reference De Visschere, Pieter Julien Luc ; Naesens, Leslie ; Libbrecht, Louis ; Van Praet, Charles ; Lumen, Nicolaas ; et. al. What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?. In: European Radiology : journal of the European Congress of Radiology, Vol. 26, no.4, p. 1098-1107 (2016)
Permanent URL http://hdl.handle.net/2078.1/186987