European Radiology

, Volume 19, Issue 3, pp 770–778 | Cite as

Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

  • Alexandre Ben Cheikh
  • Nicolas Girouin
  • Marc Colombel
  • Jean-Marie Maréchal
  • Albert Gelet
  • Alvine Bissery
  • Muriel Rabilloud
  • Denis Lyonnet
  • Olivier Rouvière
Urogenital

Abstract

We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV.

Keywords

Prostate cancer MRI Dynamic contrast-enhanced MRI Prostate biopsy 

References

  1. 1.
    Hodge KK, McNeal JE, Terris MK et al (1989) Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 142:71–74PubMedGoogle Scholar
  2. 2.
    Sadeghi-Nejad H, Simmons M, Dakwar G et al (2006) Controversies in transrectal ultrasonography and prostate biopsy. Ultrasound Q 22:169–175CrossRefPubMedGoogle Scholar
  3. 3.
    Presti JC Jr., O’Dowd GJ, Miller MC et al (2003) Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol 169:125–129CrossRefPubMedGoogle Scholar
  4. 4.
    Gore JL, Shariat SF, Miles BJ et al (2001) Optimal combinations of systematic sextant and laterally directed biopsies for the detection of prostate cancer. J Urol 165:1554–1559CrossRefPubMedGoogle Scholar
  5. 5.
    Scattoni V, Zlotta A, Montironi R et al (2007) Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. Eur Urol 52:1309–1322CrossRefPubMedGoogle Scholar
  6. 6.
    Levine MA, Ittman M, Melamed J et al (1998) Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer. J Urol 159:471–475CrossRefPubMedGoogle Scholar
  7. 7.
    Chang JJ, Shinohara K, Bhargava V et al (1998) Prospective evaluation of lateral biopsies of the peripheral zone for prostate cancer detection. J Urol 160:2111–2114CrossRefPubMedGoogle Scholar
  8. 8.
    King CR, McNeal JE, Gill H et al (2004) Extended prostate biopsy scheme improves reliability of Gleason grading: implications for radiotherapy patients. Int J Radiat Oncol Biol Phys 59:386–391PubMedGoogle Scholar
  9. 9.
    Singh H, Canto EI, Shariat SF et al (2004) Predictors of prostate cancer after initial negative systematic 12 core biopsy. J Urol 171:1850–1854CrossRefPubMedGoogle Scholar
  10. 10.
    Mian BM, Naya Y, Okihara K et al (2002) Predictors of cancer in repeat extended multisite prostate biopsy in men with previous negative extended multisite biopsy. Urology 60:836–840CrossRefPubMedGoogle Scholar
  11. 11.
    Stewart CS, Leibovich BC, Weaver AL et al (2001) Prostate cancer diagnosis using a saturation needle biopsy technique after previous negative sextant biopsies. J Urol 166:86–91CrossRefPubMedGoogle Scholar
  12. 12.
    Djavan B, Remzi M, Marberger M (2003) When to biopsy and when to stop biopsying. Urol Clin North Am 30:253–262 viiiCrossRefPubMedGoogle Scholar
  13. 13.
    Busby JE, Evans CP (2004) Determining variables for repeat prostate biopsy. Prostate Cancer Prostatic Dis 7:93–98CrossRefPubMedGoogle Scholar
  14. 14.
    Park SJ, Miyake H, Hara I et al (2003) Predictors of prostate cancer on repeat transrectal ultrasound-guided systematic prostate biopsy. Int J Urol 10:68–71CrossRefPubMedGoogle Scholar
  15. 15.
    Djavan B, Zlotta A, Remzi M et al (2000) Optimal predictors of prostate cancer on repeat prostate biopsy: a prospective study of 1,051 men. J Urol 163:1144–1148CrossRefPubMedGoogle Scholar
  16. 16.
    Zackrisson B, Aus G, Lilja H et al (2003) Follow-up of men with elevated prostate-specific antigen and one set of benign biopsies at prostate cancer screening. Eur Urol 43:327–332CrossRefPubMedGoogle Scholar
  17. 17.
    Rouviere O, Hartman RP, Lyonnet D (2006) Prostate MR imaging at high-field strength: evolution or revolution? Eur Radiol 16:276–284CrossRefPubMedGoogle Scholar
  18. 18.
    Kirkham AP, Emberton M, Allen C (2006) How good is MRI at detecting and characterising cancer within the prostate? Eur Urol 50:1163–1174CrossRefPubMedGoogle Scholar
  19. 19.
    Girouin N, Mege-Lechevallier F, Tonina Senes A et al (2007) Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable? Eur Radiol 17:1498–1509CrossRefPubMedGoogle Scholar
  20. 20.
    Villers A, Puech P, Mouton D et al (2006) Dynamic contrast enhanced, pelvic phased array magnetic resonance imaging of localized prostate cancer for predicting tumor volume: correlation with radical prostatectomy findings. J Urol 176:2432–2437CrossRefPubMedGoogle Scholar
  21. 21.
    Kim JK, Hong SS, Choi YJ et al (2005) Wash-in rate on the basis of dynamic contrast-enhanced MRI: usefulness for prostate cancer detection and localization. J Magn Reson Imaging 22:639–646CrossRefPubMedGoogle Scholar
  22. 22.
    Futterer JJ, Heijmink SW, Scheenen TW et al (2006) Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. Radiology 241:449–458CrossRefPubMedGoogle Scholar
  23. 23.
    Akin O, Sala E, Moskowitz CS et al (2006) Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. Radiology 239:784–792CrossRefPubMedGoogle Scholar
  24. 24.
    Rouviere O, Raudrant A, Ecochard R et al (2003) Characterization of time-enhancement curves of benign and malignant prostate tissue at dynamic MR imaging. Eur Radiol 13:931–942PubMedGoogle Scholar
  25. 25.
    Naughton CK, Ornstein DK, Smith DS et al (2000) Pain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomized trial of 6 versus 12 cores. J Urol 163:168–171CrossRefPubMedGoogle Scholar
  26. 26.
    Beyersdorff D, Taupitz M, Winkelmann B et al (2002) Patients with a history of elevated prostate-specific antigen levels and negative transrectal US-guided quadrant or sextant biopsy results: value of MR imaging. Radiology 224:701–706CrossRefPubMedGoogle Scholar
  27. 27.
    Perrotti M, Han KR, Epstein RE et al (1999) Prospective evaluation of endorectal magnetic resonance imaging to detect tumor foci in men with prior negative prostastic biopsy: a pilot study. J Urol 162:1314–1317CrossRefPubMedGoogle Scholar
  28. 28.
    Lattouf JB, Grubb RL 3rd, Lee SJ et al (2007) Magnetic resonance imaging-directed transrectal ultrasonography-guided biopsies in patients at risk of prostate cancer. BJU Int 99:1041–1046CrossRefPubMedGoogle Scholar
  29. 29.
    Portalez D, Malavaud B, Herigault G et al (2004) Predicting prostate cancer with dynamic endorectal coil MR and proton spectroscopic MR imaging. J Radiol 85:1999–2004PubMedGoogle Scholar
  30. 30.
    Cirillo S, Petracchini M, Della Monica P et al (2008) Value of endorectal MRI and MRS in patients with elevated prostate-specific antigen levels and previous negative biopsies to localize peripheral zone tumours. Clin Radiol 63:871–879CrossRefPubMedGoogle Scholar
  31. 31.
    Yuen JS, Thng CH, Tan PH et al (2004) Endorectal magnetic resonance imaging and spectroscopy for the detection of tumor foci in men with prior negative transrectal ultrasound prostate biopsy. J Urol 171:1482–1486CrossRefPubMedGoogle Scholar
  32. 32.
    Shukla-Dave A, Hricak H, Eberhardt SC et al (2004) Chronic prostatitis: MR imaging and 1H MR spectroscopic imaging findings–initial observations. Radiology 231:717–724CrossRefPubMedGoogle Scholar
  33. 33.
    Futterer JJ, Engelbrecht MR, Jager GJ et al (2007) Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal-pelvic phased-array coils. Local staging accuracy of prostate cancer using endorectal coil MR imaging. Eur Radiol 17:1055–1065CrossRefPubMedGoogle Scholar
  34. 34.
    Puech PFJ, Ballereau C, Leroy X, Villers A, Lemaître L (2004) Etude comparative de l’IRM de prostate par voie suspubienne ou endorectale. J Radiol 85:1402CrossRefGoogle Scholar
  35. 35.
    Futterer JJ, Heijmink SW, Scheenen TW et al (2006) Prostate cancer: local staging at 3-T endorectal MR imaging–early experience. Radiology 238:184–191CrossRefPubMedGoogle Scholar
  36. 36.
    Heijmink SW, Futterer JJ, Hambrock T et al (2007) Prostate cancer: body-array versus endorectal coil MR imaging at 3 T–comparison of image quality, localization, and staging performance. Radiology 244:184–195CrossRefPubMedGoogle Scholar
  37. 37.
    Anastasiadis AG, Lichy MP, Nagele U et al (2006) MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 50:738–748CrossRefPubMedGoogle Scholar
  38. 38.
    Singh AK, Kruecker J, Xu S et al (2008) Initial clinical experience with real-time transrectal ultrasonography-magnetic resonance imaging fusion-guided prostate biopsy. BJU Int 101:841–845CrossRefPubMedGoogle Scholar
  39. 39.
    Heijmink SW, van Moerkerk H, Kiemeney LA et al (2006) A comparison of the diagnostic performance of systematic versus ultrasound-guided biopsies of prostate cancer. Eur Radiol 16:927–938CrossRefPubMedGoogle Scholar
  40. 40.
    Mitterberger M, Pinggera GM, Horninger W et al (2007) Comparison of contrast enhanced color Doppler targeted biopsy to conventional systematic biopsy: impact on Gleason score. J Urol 178:464–468CrossRefPubMedGoogle Scholar
  41. 41.
    Remzi M, Dobrovits M, Reissigl A et al (2004) Can Power Doppler enhanced transrectal ultrasound guided biopsy improve prostate cancer detection on first and repeat prostate biopsy? Eur Urol 46:451–456PubMedGoogle Scholar
  42. 42.
    Ito H, Kamoi K, Yokoyama K et al (2003) Visualization of prostate cancer using dynamic contrast-enhanced MRI: comparison with transrectal power Doppler ultrasound. Br J Radiol 76:617–624CrossRefPubMedGoogle Scholar
  43. 43.
    Konig K, Scheipers U, Pesavento A et al (2005) Initial experiences with real-time elastography guided biopsies of the prostate. J Urol 174:115–117CrossRefPubMedGoogle Scholar
  44. 44.
    Souchon R, Rouviere O, Gelet A et al (2003) Visualisation of HIFU lesions using elastography of the human prostate in vivo: preliminary results. Ultrasound Med Biol 29:1007–1015CrossRefPubMedGoogle Scholar
  45. 45.
    Pallwein L, Mitterberger M, Gradl J et al (2007) Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer. Curr Opin Urol 17:39–47CrossRefPubMedGoogle Scholar

Copyright information

© European Society of Radiology 2008

Authors and Affiliations

  • Alexandre Ben Cheikh
    • 1
    • 2
    • 3
  • Nicolas Girouin
    • 1
    • 2
    • 3
  • Marc Colombel
    • 4
  • Jean-Marie Maréchal
    • 4
  • Albert Gelet
    • 4
    • 7
  • Alvine Bissery
    • 5
    • 6
  • Muriel Rabilloud
    • 5
    • 6
  • Denis Lyonnet
    • 1
    • 2
    • 3
    • 7
  • Olivier Rouvière
    • 1
    • 2
    • 3
    • 7
    • 8
  1. 1.Hospices Civils de Lyon, Department of Urinary and Vascular RadiologyHôpital Edouard HerriotLyonFrance
  2. 2.Université de LyonLyonFrance
  3. 3.Université de Lyon 1, faculté de médecine Lyon NordLyonFrance
  4. 4.Hospices Civils de Lyon, Department of UrologyHôpital Edouard HerriotLyonFrance
  5. 5.Hospices Civils de Lyon, Department of BiostatisticsLyonFrance
  6. 6.Université de Lyon 1, UMR CNRS 5558, Laboratoire Biostatistiques-SantéPierre-BéniteFrance
  7. 7.Inserm, U556LyonFrance
  8. 8.Department of Urinary and Vascular Radiology, Pavillon P RadioHôpital Edouard HerriotLyon Cedex 03France

Personalised recommendations