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Is it possible to model the risk of malignancy of focal abnormalities found at prostate multiparametric MRI?

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Abstract

Objective

To evaluate whether focal abnormalities (FAs) depicted by prostate MRI could be characterised using simple semiological features.

Methods

134 patients who underwent T2-weighted, diffusion-weighted and dynamic contrast-enhanced MRI at 1.5 T before prostate biopsy were prospectively included. FAs visible at MRI were characterised by their shape, the degree of signal abnormality (0 = normal to 3 = markedly abnormal) on individual MR sequences, and a subjective score (SS1 = probably benign to SS3 = probably malignant). FAs were then biopsied under US guidance.

Results

56/233 FAs were positive at biopsy. The subjective score significantly predicted biopsy results (P < 0.01). As compared to SS1 FAs, the odds ratios (OR) of malignancy of SS2 and SS3 FAs were 9.9 (1.8–55.9) and 163.8 (11.5–2331). Unlike FAs’ shape, a simple combination of MR signal abnormalities (into “low-risk”, “intermediate” and “high-risk” groups) significantly predicted biopsy results (P < 0.008). As compared to “low risk” FAs, the OR of malignancy of “intermediate” and “high-risk” FAs were 4.5 (1.1–18.4) and 52.7 (6.8–407) in the overall population and 5.4 (1.1–27.2) and 118.2 (6.1–2301) in PZ.

Conclusions

A simple combination of signal abnormalities of individual MR sequences can significantly stratify the risk of malignancy of FAs, holding promise of a more standardised interpretation of MRI by readers with varying experience.

Key Points

• Using multiparameter(mp)-MRI, experienced uroradiologists can stratify the malignancy risk of prostatic lesions

• The shape of prostatic focal abnormalities in the peripheral zone does not help predicting malignancy.

• A simple combination of findings at mp-MRI can help less-experienced radiologists

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Authors and Affiliations

  1. Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France

    Olivier Rouvière, Matthieu Papillard, Nicolas Girouin & Romain Boutier

  2. Université de Lyon, Lyon, France

    Olivier Rouvière, Matthieu Papillard, Nicolas Girouin & Romain Boutier

  3. Université Lyon 1, faculté de médecine Lyon Est, Lyon, France

    Olivier Rouvière, Matthieu Papillard, Nicolas Girouin & Romain Boutier

  4. Hospices Civils de Lyon, Department of Biostatistics, Lyon, France

    Muriel Rabilloud & Benjamin Riche

  5. Université Lyon 1, UMR CNRS 5558, Laboratoire Biostatistiques-Santé, Pierre-Bénite, France

    Muriel Rabilloud & Benjamin Riche

  6. Hospices Civils de Lyon, Department of Pathology, Hôpital Edouard Herriot, Lyon, France

    Florence Mège-Lechevallier

  7. Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, France

    Marc Colombel & Albert Gelet

  8. Inserm, U556, Lyon, 69424, France

    Olivier Rouvière & Albert Gelet

  9. Department of Urinary and Vascular Radiology, Pavillon P Radio, Hôpital Edouard Herriot, 69437, Lyon Cedex 03, France

    Olivier Rouvière

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  1. Olivier Rouvière
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  2. Matthieu Papillard
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  3. Nicolas Girouin
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  7. Florence Mège-Lechevallier
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  9. Albert Gelet
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Correspondence to Olivier Rouvière.

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Rouvière, O., Papillard, M., Girouin, N. et al. Is it possible to model the risk of malignancy of focal abnormalities found at prostate multiparametric MRI?. Eur Radiol 22, 1149–1157 (2012). https://doi.org/10.1007/s00330-011-2343-8

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  • DOI: https://doi.org/10.1007/s00330-011-2343-8

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