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MRI-based analysis of different clinically significant prostate cancer detection rate of prostate imaging reporting and data system score 4 in the peripheral zone

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Abstract

Purpose

To compare the clinically significant prostate cancer (csPCa) detection rate between diffusion-weighted imaging (DWI) 4 and DWI 3 with positive dynamic contrast-enhanced (DCE) (hereinafter called ‘DWI 3/DCE+’) lesions in the peripheral zone (PZ) and to explore the diagnostic performance of targeted biopsy (TB) or systematic biopsy (SB) in patients with Prostate Imaging Reporting and Data System (PI-RADS) 4 lesions.

Methods

We retrospectively enrolled 206 patients who underwent multiparametric magnetic resonance imaging and had at least one PI-RADS 4 lesion in the PZ. All patients subsequently underwent combined magnetic resonance imaging/ultrasound fusion-guided TB and ultrasound-guided 12-core SB. The chi-square test was used to compare the csPCa detection rates between DWI 4 and DWI 3/DCE+ lesions. Based on the TB + SB results as a standard reference, we analyzed the sensitivity, negative predictive value, and diagnostic accuracy of TB alone or SB alone.

Results

Patients with DWI 4 lesions had higher csPCa detection rate than those with DWI 3/DCE+ lesions when using TB + SB, TB, and SB, and the differences were significant for TB + SB (72.22 vs. 54.84%, p = 0.015) or SB (65.97 vs. 46.77%, p = 0.010). For DWI 3/DCE+ patients whose prostate-specific antigen levels ranged from 4 to 10 ng/mL, TB alone showed the highest negative predictive value (95% Cl 78.12–100).

Conclusions

DWI 4 tends to have worse results than DWI 3/DCE+. TB has great diagnostic performances in DWI 3/DCE+ patients, especially for those prostate-specific antigen ranging from 4 to 10 ng/mL.

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Funding

This work was supported by the National Key Research and Development Program of China (Grant Nos. 2021YFC2009300 and 2021YFC2009301).

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Author notes

  1. Gang Song

    Present address: Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

Authors and Affiliations

  1. Department of Urology, Peking University First Hospital, No.8 Xishiku St. Xicheng District, Beijing, 100034, China

    Zhoujie Sun, Weixiao Fu & Gang Song

  2. Institute of Urology, Peking University, Beijing, 100034, China

    Zhoujie Sun, Weixiao Fu & Gang Song

  3. The National Urological Cancer Center of China, Beijing, 100034, China

    Zhoujie Sun, Weixiao Fu & Gang Song

  4. Department of Radiology, Peking University First Hospital, Beijing, 100034, China

    He Wang

  5. Department of Statistics, Peking University First Hospital, Beijing, 100034, China

    Sainan Zhu

Authors
  1. Zhoujie Sun
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Zhoujie Sun, He Wang, Weixiao Fu, Sainan Zhu and Gang Song. The first draft of the manuscript was written by Zhoujie Sun and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Conceptualization: Gang Song, Zhoujie Sun; Methodology: Gang Song, Zhoujie Sun; Formal analysis and investigation: He Wang, Weixiao Fu, Sainan Zhu; Writing—original draft preparation: Zhoujie Sun; Writing—review and editing: Gang Song, He Wang; Funding acquisition: Gang Song; Resources: Gang Song, He Wang; Supervision: Gang Song.

Corresponding author

Correspondence to Gang Song.

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The authors declare that they have no conflict of interest.

Ethics approval

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards, and approved by the Ethics Committee of Peking University First Hospital (protocol code 2016-1275).

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Informed consent was obtained from all subjects involved in the study.

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Sun, Z., Wang, H., Fu, W. et al. MRI-based analysis of different clinically significant prostate cancer detection rate of prostate imaging reporting and data system score 4 in the peripheral zone. Abdom Radiol 48, 390–398 (2023). https://doi.org/10.1007/s00261-022-03712-0

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  • DOI: https://doi.org/10.1007/s00261-022-03712-0

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