ORLANDO, FL USA (UroToday.com) - Multiparametric MRI (mp-MRI) is important in the detection of prostate cancer. Mohamed Abd-Alazeez presented results of his group's study on MRI imaging in which they evaluated the performance of various MRI sequences and their ability to detect prostate cancer. The study was comprised of a cohort of 37 men who had presented after prostate radiotherapy. The authors compared mp-MRI with T2-wighted, diffusion-weighted and dynamic contrast-enhanced imaging. Their cohort of patients were followed with subsequent prostate biopsies within 10 months of their imaging. Their comparison was drawn from rating scores of 2 independent radiologists.
They found that 66% of hemi-glands of prostates were positive for cancer on template-prostate mapping biopsy. The authors also showed that detection was worse with T2-weighted imaging compared to mp-MRI, both in reader 1 and reader 2. The inter-rater reliability was also calculated, which is important in a study with two reviewers. The authors reported substantial agreement between the readers.
They concluded that mp-MRI is a more accurate method than T2-weighted imaging in detecting prostate cancer in patients who have already had radiation therapy for their tumors. The authors recommended that in a similar situation, when a T2 weighted sequence is used, high b value DWI or ADC map should be included as part of the imaging protocol. With the current study, given that the agreement is substantial between reviewers, it would be beneficial if the data from the two reviewers were combined, given that the primary goal was to compare the two different sequences of MRI. This study is timely as it brings up the idea of over diagnosis of prostate cancer. More accurate methods of detecting significant prostate cancer are needed to prevent unnecessary treatment.
Presented by Mohamed Abd-Alazeez, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
London, United Kingdom
Written by Garen Abedi, MD, University of California (Irvine), and medical writer for UroToday.com