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Comparison between biparametric and multiparametric MRI diagnosis strategy for prostate cancer in the peripheral zone using PI-RADS version 2.1

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Abstract

Purpose

To compare and analyse the diagnostic value of PI-RADS v2.1 when used with biparametric MRI (bpMRI) versus multiparametric MRI (mpMRI), DWI versus T2WI to detect peripheral-zone prostate cancer (pzPCa) and clinically significant peripheral-zone prostate cancer (cs-pzPCa).

Methods

The diagnostic efficiencies of mpMRI and bpMRI as well as DWI and T2WI in pzPCa and cs-pzPCa were compared using a PI-RADS score of ≥ 4 as the positive threshold and prostate biopsy and radical prostatectomy as the reference standards.

Results

A total of 307 prostate cases were included in the study, including 142 in the non-pzPCa group, 165 in the pzPCa group, and 130 in the cs-pzPCa group. The AUCs of mpMRI and bpMRI were 0.717 and 0.733 (P = 0.317), respectively, for the diagnosis of pzPCa (sensitivities: 89.1% and 81.8%; specificities: 54.2% and 64.8%, both P < 0.001) and 0.594 and 0.602 (P = 0.756), respectively, for the diagnosis of cs-pzPCa (sensitivities: 93.1% and 86.2%, P = 0.004; specificities: 25.7% and 34.3%, P = 0.250). The AUCs of DWI and T2WI were 0.733 and 0.749 (P = 0.308), respectively, for the diagnosis of pzPCa (sensitivities: 81.8% and 84.2%; specificities: 64.8% and 66.2%, both P > 0.05) and 0.602 and 0.581 (P = 0.371), respectively, for the diagnosis of cs-pzPCa (sensitivities: 86.2% and 87.7%; specificities: 34.3% and 28.6%, both P > 0.05).

Conclusion

mpMRI and bpMRI as well as DWI and T2WI using PI-RADS v2.1 exhibited similar diagnostic efficiency in pzPCa and cs-pzPCa.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under curve

bpMRI:

Bi-parametric MRI

cs-pzPCa:

Clinically significant peripheral-zone prostate cancer

DCE:

Dynamic contrast enhanced

DWI:

Diffusion weighted imaging

mpMRI:

Multi-parametric MRI

NPV:

Negative predictive value

PCa:

Prostate cancer

PI-RADS:

Prostate Imaging Reporting and Data System

PPV:

Positive predictive value

PSA:

Prostate-specific antigen

pzPCa:

Peripheral-zone prostate cancer

ROC:

Receiver operating characteristic curve

T2WI:

T2-weighted imaging

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Funding

This study has received funding by the National Natural Science Foundation of China (Grant No. 91859119), the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (Grant No. 2019XK320028), the National Natural Science Foundation of China (Grant No. 81901742), the Natural Science Foundation of Beijing Municipality (Grant No. 7192176), the Central University Basic Scientific Research Business Expenses Special Funds (Grant No. 3332018022), the National Public Welfare Basic Scientific Research Project of Chinese Academy of Medical Sciences (Grant Nos. 2019PT320008 and 2018PT32003).

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Authors and Affiliations

  1. Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Jiahui Zhang, Lili Xu, Gumuyang Zhang, Xiaoxiao Zhang, Xin Bai, Hao Sun & Zhengyu Jin

  2. Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Zhigang Ji

  3. Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing Street, Dongcheng District, Beijing, 100730, China

    Yu Xiao

Authors
  1. Jiahui Zhang
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  2. Lili Xu
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  3. Gumuyang Zhang
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  4. Xiaoxiao Zhang
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  5. Xin Bai
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  6. Zhigang Ji
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  7. Yu Xiao
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  8. Hao Sun
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  9. Zhengyu Jin
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Contributions

JZ contributed to data acquisition, analysis and writing original draft preparation. LX and GZ was involved in statistical analysis and tables and figure generating. XB and XZ participated in the data measurement and summary. ZJ and YX contributed to method guidance and paper editing. HS and ZJ contributed to the idea design of the paper and the modification of the final draft.

Corresponding authors

Correspondence to Hao Sun or Zhengyu Jin.

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The authors declare that they have no competing interests.

Ethical approval

This study was conducted as per the Declaration of Helsinki. The approval to the protocol was done by our institutional Research Ethics Committee and each regulation was followed.

Informed consent

The requirement for consent was waived by the board due to the retrospective nature of the study.

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Zhang, J., Xu, L., Zhang, G. et al. Comparison between biparametric and multiparametric MRI diagnosis strategy for prostate cancer in the peripheral zone using PI-RADS version 2.1. Abdom Radiol 47, 2905–2916 (2022). https://doi.org/10.1007/s00261-022-03553-x

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  • DOI: https://doi.org/10.1007/s00261-022-03553-x

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