To analyse the characteristics of prostate cancers (PrCa) detected following negative multiparametric magnetic resonance imaging (mpMRI).
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Eight hundred and thirty patients with elevated prostate-specific antigen (mean 11.
9 μg/l) underwent mpMRI of the prostate at 1 5 Tesla with endorectal coil The characteristics of all PrCa detected within 2 years after a negative mpMRI were analysed Primary Gleason grade 4 or any grade 5 PrCa were considered high-grade (HG), Gleason score 3 + 4 intermediate grade (IG) and Gleason score ≤3 + 3 low-grade (LG) Tumour size was considered 'small' when
mpMRI was negative in 391 patients (47 1 %) In 124 patients (31 7 %) PrCa was detected within 2 years Eighty-four (67 7 %) were LG, 22 (17 7 %) IG and 18 (14 5 %) HG 119 (96 0 %) of the missed PrCa were organ-confined The negative predictive value was 95 4 % (373/391) for HG PrCa Among the 18 missed HG PrCa, 15 (83 3 %) were organ-confined and 12 (66 6 %) were small
The majority of missed tumours on mpMRI were low grade and organ-confined In patients with elevated PSA and a negative mpMRI, consideration could be given to continued surveillance rather than immediate biopsy
• The majority of missed prostate cancers were low grade and organ-confined • In patients with a negative mpMRI a biopsy may be postponed • mpMRI had a negative predictive value of 95 4 % for high-grade prostate cancer
European radiology 2015 Jul 03 [Epub ahead of print]
Pieter Julien Luc De Visschere, Leslie Naesens, Louis Libbrecht, Charles Van Praet, Nicolaas Lumen, Valérie Fonteyne, Eva Pattyn, Geert Villeirs
Department of Radiology, Ghent University Hospital, 0 DPP, De Pintelaan 185, 9000, Gent, Belgium, pieter devisschere@uzgent be