Zidan, A., Mahmoud, A., Said, A., Abdulallah, R. (2023). Efficacy of Pelvic Diffusion Weighted MRI Prior to Prostate Biopsy in Patients with elevated tPSA Level for Determination of Malignant Lesions. test, 4(2), 76-91. doi: 10.21608/ejmr.2022.112787.1175
Ahmed Abdel Fattah Zidan; Amany Rady Mahmoud; Ahmed Hesham Said; Rabee Mohammed Abdulallah. "Efficacy of Pelvic Diffusion Weighted MRI Prior to Prostate Biopsy in Patients with elevated tPSA Level for Determination of Malignant Lesions". test, 4, 2, 2023, 76-91. doi: 10.21608/ejmr.2022.112787.1175
Zidan, A., Mahmoud, A., Said, A., Abdulallah, R. (2023). 'Efficacy of Pelvic Diffusion Weighted MRI Prior to Prostate Biopsy in Patients with elevated tPSA Level for Determination of Malignant Lesions', test, 4(2), pp. 76-91. doi: 10.21608/ejmr.2022.112787.1175
Zidan, A., Mahmoud, A., Said, A., Abdulallah, R. Efficacy of Pelvic Diffusion Weighted MRI Prior to Prostate Biopsy in Patients with elevated tPSA Level for Determination of Malignant Lesions. test, 2023; 4(2): 76-91. doi: 10.21608/ejmr.2022.112787.1175

Efficacy of Pelvic Diffusion Weighted MRI Prior to Prostate Biopsy in Patients with elevated tPSA Level for Determination of Malignant Lesions

Egyptian Journal of Medical Research
Volume 4, Issue 2, April 2023, Pages 76-91    PDF (674.55 K)
Document Type: Original Article
DOI: 10.21608/ejmr.2022.112787.1175
Authors
Ahmed Abdel Fattah Zidan1; Amany Rady Mahmoud* 2; Ahmed Hesham Said1; Rabee Mohammed Abdulallah3
1Radiology department, Faculty of medicine, Beni_Suef University, Egypt.
2Radiology department, Elwasta central hospital, MOPH.
3Urology department, Faculty of medicine, Beni_Suef University, Egypt.
Abstract
Aim: the aim of this research to examine the influence of TRUS-guided biopsy samples from specified lesions in diffusion-weighted MRI on the detection rate of prostate cancer (MRI). Patients and Methods: This study cross sectional analytical study with follow up the results of biopsy was conducted on 25 patients with elevated PSA from 2.5 to 20 ng/ml undergone diffusion weighted MRI before TRUS guided biopsy. Patients were referred to the diagnostic radiology department from the outpatient clinic of urology department at Beni-Suef University Hospital from September 2018 to December 2020.The study explained to all participants and written informed consent taken from them before starting the  study and the approval of ethical committee of Beni-Suef was taken. Results: There were 72% of the studied patients had benign prostatic lesions and 28% had malignant lesions. There was a statistically significant higher level of PSA among patients with restricted MRI diffusion than who had normal MRI diffusion (P-value=0.030). The sensitivity of MRI diffusion in detection of malignant prostate masses was 71.4% its specificity was 94.4% %, the PPV was 83.3% and the NPV was 89.5%. Conclusion: In conclusion, transrectal ultrasonography (TRUS) guided biopsy samples from pre-determined lesions in diffusion-weighted MRI (MRI) resulted in an increase in the detection rate of prostate cancer while lowering the excessive biopsy rate.
Keywords
DWI; MRI; Prostate; tPSA
References
  1. Engholm G, Ferlay J, Christensen N, Bray F, Gjerstorff ML, Klint Å, Køtlum JE, Ólafsdóttir E, Pukkala E, Storm HH. NORDCAN–a Nordic tool for cancer information, planning, quality control and research. Acta oncologica. 2010;49(5):725-36.
  2. Kwak C, Ku JH, Kim T, Choi KY, Lee E, Lee SE, Lee C. Effect of subclinical prostatic inflammation on serum PSA levels in men with clinically undetectable prostate cancer. Urology. 2003;62(5):854-9.
  3. Djavan BO, Ravery V, Zlotta A, Dobronski P, Dobrovits M, Fakhari M, Seitz C, Susani M, Borkowski A, Boccon-Gibod L, Schulman CC. Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop?. The Journal of urology. 2001;166(5):1679-83.
  4. Copple IM, Goldring CE, Kitteringham NR, Park BK. The Nrf2–Keap1 defence pathway: role in protection against drug-induced toxicity. Toxicology. 2008;246(1):24-33.
  5. Dickinson L, Ahmed HU, Allen C, Barentsz JO, Carey B, Futterer JJ, Heijmink SW, Hoskin PJ, Kirkham A, Padhani AR, Persad R. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. European urology. 2011;59(4):477-94.
  6. Iwata Y, Matsushita T, Horikawa M, DiLillo DJ, Yanaba K, Venturi GM, Szabolcs PM, Bernstein SH, Magro CM, Williams AD, Hall RP. Characterization of a rare IL-10–competent B-cell subset in humans that parallels mouse regulatory B10 cells. Blood, The Journal of the American Society of Hematology. 2011;117(2):530-41.
  7. Hambrock T, Somford DM, Huisman HJ, van Oort IM, Witjes JA, Hulsbergen-van de Kaa CA, Scheenen T, Barentsz JO. Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer. Radiology. 2011 May;259(2):453-61.
  8. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, Kwiatkowski M, Lujan M, Lilja H, Zappa M, Denis LJ. Screening and prostate-cancer mortality in a randomized European study. New England journal of medicine. 2009 Mar 26;360(13):1320-8.
  9. Hoeks CM, Vos EK, Bomers JG, Barentsz JO, Hulsbergen-van de Kaa CA, Scheenen TW. Diffusion-weighted magnetic resonance imaging in the prostate transition zone: histopathological validation using magnetic resonance–guided biopsy specimens. Investigative radiology. 2013;48(10):693-701.
  10. Andriole GL, Crawford ED, Grubb III RL, Buys SS, Chia D, Church TR, Fouad MN, Gelmann EP, Kvale PA, Reding DJ, Weissfeld JL. Mortality results from a randomized prostate-cancer screening trial. New England Journal of Medicine. 2009;360(13):1310-9.
  11. Delongchamps NB, Singh A, Haas GP. The role of prevalence in the diagnosis of prostate cancer. Cancer Control. 2006;13(3):158-68.
  12. Djavan BO, Ravery V, Zlotta A, Dobronski P, Dobrovits M, Fakhari M, Seitz C, Susani M, Borkowski A, Boccon-Gibod L, Schulman CC. Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: when should we stop?. The Journal of urology. 2001;166(5):1679-83.
  13. Rosenkrantz AB, Verma S, Turkbey B. Prostate cancer: top places where tumors hide on multiparametric MRI. American Journal of Roentgenology. 2015;204(4):W449-56.
  14. Moyer VA. Screening for prostate cancer: US Preventive Services Task Force recommendation statement. Annals of internal medicine. 2012;157(2):120-34.
  15. Kim JK, Jang YJ, Cho G. Multidisciplinary functional MR imaging for prostate cancer. Korean journal of radiology. 2009;10(6):535-51.
  16. Shah ZK, Elias SN, Abaza R, Zynger DL, DeRenne LA, Knopp MV, Guo B, Schurr R, Heymsfield SB, Jia G. Performance comparison of 1.5-T endorectal coil MRI with 3.0-T nonendorectal coil MRI in patients with prostate cancer. Academic radiology. 2015 Apr 1;22(4):467-74.
  17. Yoo S, Kim JK, Jeong IG. Multiparametric magnetic resonance imaging for prostate cancer: A review and update for urologists. Korean journal of urology. 2015;56(7):487-97.
  18. Yerram NK, Volkin D, Turkbey B, Nix J, Hoang AN, Vourganti S, Gupta GN, Linehan WM, Choyke PL, Wood BJ, Pinto PA. Low Suspicion Lesions on Multiparametric Magnetic Resonance Imaging Predict for the Absence of High Risk Prostate Cancer. BJU international. 2012;110(11 0 0).
  19. Gupta RT, Kauffman CR, Polascik TJ, Taneja SS, Rosenkrantz AB. The state of prostate MRI in 2013. Oncology (Williston Park). 2013;27(4):262-70.
  20. Umbehr M, Bachmann LM, Held U, Kessler TM, Sulser T, Weishaupt D, Kurhanewicz J, Steurer J. Combined magnetic resonance imaging and magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer: a systematic review and meta-analysis. European urology. 2009;55(3):575-91.
  21. Pinto PA, Chung PH, Rastinehad AR, Baccala AA, Kruecker J, Benjamin CJ, Xu S, Yan P, Kadoury S, Chua C, Locklin JK. Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. The Journal of urology. 2011;186(4):1281-5.
  22. Stamatakis L, Siddiqui MM, Nix JW, Logan J, Rais‐Bahrami S, Walton‐Diaz A, Hoang AN, Vourganti S, Truong H, Shuch B, Parnes HL. Accuracy of multiparametric magnetic resonance imaging in confirming eligibility for active surveillance for men with prostate cancer. Cancer. 2013;119(18):3359-66.
  23. Rais-Bahrami S, Siddiqui MM, Vourganti S, Turkbey B, Rastinehad AR, Stamatakis L, Truong H, Walton-Diaz A, Hoang AN, Nix JW, Merino MJ. Diagnostic value of biparametric magnetic resonance imaging (MRI) as an adjunct to prostate-specific antigen (PSA)-based detection of prostate cancer in men without prior biopsies. BJU international. 2015;115(3):381.
  24. Tamada T, Sone T, Jo Y, Yamamoto A, Ito K. Diffusion‐weighted MRI and its role in prostate cancer. NMR in Biomedicine. 2014;27(1):25-38.
  25. Yagci AB, Özari N, Aybek Z, Düzcan E. The value of diffusion-weighted MRI for prostate cancer detection and localization. Diagnostic and Interventional Radiology. 2011;17(2):130.
  26. Kitajima K, Takahashi S, Ueno Y, Yoshikawa T, Ohno Y, Obara M, Miyake H, Fujisawa M, Sugimura K. Clinical utility of apparent diffusion coefficient values obtained using high b‐value when diagnosing prostate cancer using 3 tesla MRI: Comparison between ultra‐high b‐value (2000 s/mm2) and standard high b‐value (1000 s/mm2). Journal of Magnetic Resonance Imaging. 2012;36(1):198-205.
  27. Haider MA, Van Der Kwast TH, Tanguay J, Evans AJ, Hashmi AT, Lockwood G, Trachtenberg J. Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. American journal of roentgenology. 2007;189(2):323-8.
  28. Rao SX, Zeng MS, Chen CZ, Li RC, Zhang SJ, Xu JM, Hou YY. The value of diffusion-weighted imaging in combination with T2-weighted imaging for rectal cancer detection. European journal of radiology. 2008;65(2):299-303.
  29. Gibbs P, Tozer DJ, Liney GP, Turnbull LW. Comparison of quantitative T2 mapping and diffusion‐weighted imaging in the normal and pathologic prostate. Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine. 2001;46(6):1054-8.
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