Reliability of prostate imaging reporting and data system version 2.1 for excluding clinically significant prostate cancer using a 1.5 tesla scanner

Introduction Multiparametric magnetic resonance imaging (mpMRI) of the prostate gland is now the recommended initial investigation of choice for the detection of Prostate cancer (PCa). It effectively identifies patients who require prostate biopsies due to the risk of clinically significant PCa. It...

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Bibliographic Details
Published in:BMC urology Vol. 23; no. 1; pp. 69 - 6
Main Authors: Sharqawi, Abdallah, Drye, Naomi, Shugaba, Abdul, O’reilly, Alison, Kadry, Ahmed M., El-Sakka, A I
Format: Journal Article
Language:English
Published: London BioMed Central 28.04.2023
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Biopsy
Clinical significance
Clinical trials
Clinically significant prostate cancer
Family medical history
Humans
Image-Guided Biopsy - methods
Internal Medicine
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Multiparametric Magnetic Resonance Imaging
Patients
Perineum
PI-RADS score
Prostate - pathology
Prostate cancer
Prostatic Neoplasms - pathology
Reproducibility of Results
Retrospective Studies
Statistical analysis
Trans perineal prostate biopsy
Urology
Clinically significant prostate cancer
Multiparametric magnetic resonance imaging
Trans perineal prostate biopsy
PI-RADS score
ISSN:1471-2490, 1471-2490
Online Access:Get full text
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Summary:Introduction Multiparametric magnetic resonance imaging (mpMRI) of the prostate gland is now the recommended initial investigation of choice for the detection of Prostate cancer (PCa). It effectively identifies patients who require prostate biopsies due to the risk of clinically significant PCa. It helps patients with clinically insignificant PCa avoid the invasive biopsies and possible accompanying complications. Large clinical trials have investigated the accuracy of mpMRI in detecting PCa. We performed a local review to examine the reliability of omitting tissue sampling in men with a negative (PIRADS 2 (P2) or less) mpMRI in the primary diagnostic setting. Methods This was a retrospective study of patients with clinical suspicion of PCa within a 2-year period. Patients had a mpMRI prior to having trans-perineal prostate gland biopsies. Clinically significant disease was defined as Gleason 7 and above. The descriptive data was analysed using contingency table methods. A p-value less than 0.05 was statistically significant. Results Out of 700 patients 90 had an mpMRI score of PIRADS 2. Seventy-seven (85.5%) of these patients had a negative biopsy, 9(10%) showed Gleason 6, 4 patients showed Gleason 7 or above. 78 patients with PIRADS 2 had a PSA density of < 0.15, none of which had a clinically significant biopsy result. The negative predictive value of mpMRI from this study is 95%. Conclusion Our results are in line with negative predictive values demonstrated in the current literature. This local study, likely applicable to other district general hospitals, shows that mpMRI is a safe and reliable initial investigation to aid decisions on which patients require biopsies.
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ISSN:1471-2490
1471-2490
DOI:10.1186/s12894-023-01241-6