The aim of the study was to compare the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI), multiparametric ultrasound (mpUS) and US/MRI fusion imaging techniques in the detection of prostate cancer.
A total of 82 patients with persistently high prostate specific antigen (PSA) levels after medical therapy were prospectively evaluated. All patients underwent digital rectal examination, mpMRI, mpUS and prostate biopsy.
Histological outcome was positive for prostate cancer (PCa) in 46/82 patients (56.1%). MpMRI detected 54/82 lesions; histological analysis confirmed PCa in 44 lesions (sensitivity 91.3% and specificity 66.7%). Ratio estimation with semiquantitative elastography, between lesions and the peripheral portion showed a higher sensitivity and specificity compared to strain ration (SR) evaluation between lesions and adenomas (sensitivity 84.8% vs. 78.3%; specificity 66.6% vs. 61.1%). Quantitative analysis of contrast-enhanced ultrasound (CEUS) showed 40.0% sensitivity and 97.2% specificity. A total of 54 lesions detected by mpMRI and MRI/TRUS fusion targeted biopsy had a high number of positive samples (81.5%).
mpMRI is more accurate than mpUS which still remains a valuable technique used after MRI for prostate fusion-guided biopsy.
Anticancer research. 2019 Jun [Epub]
Francesco M Drudi, Vito Cantisani, Flavia Angelini, Mauro Ciccariello, Daniela Messineo, Evaristo Ettorre, Mauro Liberatore, Michele Scialpi
Department of Radiological, Oncological and Pathological anatomy Sciences, Sapienza University of Rome, Rome, Italy ., Department of Radiological, Oncological and Pathological anatomy Sciences, Sapienza University of Rome, Rome, Italy., Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric, Sapienza University of Rome, Rome, Italy., Section of Diagnostic Imaging, Department of Surgical and Biomedical Sciences, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.