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The following is a summary of “Values of multiparametric and biparametric MRI in diagnosing clinically significant prostate cancer: a multivariate analysis,” published in the February 2024 issue of Urology by Feng et al.
This study sought to assess the diagnostic efficacy of semi-quantitative and quantitative parameters derived from multiparametric MRI (mpMRI) or biparametric MRI (bpMRI), in conjunction with prostate-specific antigen density (PSAD), for detecting clinically significant prostate cancer (csPCa). A cohort of 561 patients with biopsy-confirmed prostate diseases, comprising 276 cases of csPCa and 285 cases of non-csPCa, underwent preoperative mpMRI. Prostate volume was determined for PSAD calculation, and index lesions were evaluated using T2WI and mpMRI based on the PI-RADS v2.1 scoring system.
Additionally, quantitative parameters, including apparent diffusion coefficient (ADC), Ktrans, and Kep values, were derived from DWI and DCE-MRI images for the index lesion. Logistic regression analysis identified predictors of csPCa, and predictive models were established for bpMRI and mpMRI. These models’ diagnostic accuracy and individual parameters wereu assessed using ROC curves. Results indicated that PSA density, PI-RADS score, T2WI score, ADCrec, Ktrans, and Kep exhibited independent diagnostic accuracies of 80.2%, 89.5%, 88.3%, 84.6%, 58.5%, and 61.6%, respectively. Notably, combining T2WI score and ADC value with PSAD in the bpMRI model yielded higher diagnostic accuracy than the PI-RADS score alone. However, the mpMRI model incorporating PI-RADS score and ADC value with PSAD demonstrated the highest diagnostic accuracy overall.
In conclusion, the PI-RADS score based on the PI-RADS v2.1 standard emerged as the most accurate independent diagnostic index. While the predictive value of the bpMRI model for csPCa was slightly inferior to that of mpMRI, it still outperformed the PI-RADS score alone, highlighting its clinical utility in csPCa diagnosis.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01411-0