MpMRI Articles

We evaluated the ability to detect clinically significant prostate cancer (CS-PCa) using a novel electromagnetically (EM) tracked transperineal MR/US fusion guided targeted biopsy (tpTBx) platform and the impact of inter-reader variability on cancer detection.

The added value of non-targeted systematic prostate biopsies (NT-PBx), when performed alongside MRI-targeted biopsies (T-PBx), in men referred with a suspicion of prostate cancer is unclear. We aimed to determine the clinical utility of transperineal NT-Bx, when performed alongside T-Bx, using pre-biopsy multiparametric magnetic resonance imaging (mpMRI).

To develop and externally validate a predictive model for detection of significant prostate cancer (PC).

Development of the model was based on prospective cohort including 393 men who underwent mpMRI prior to biopsy.

We investigated the accuracy of multiparametric MRI (mpMRI) for preoperative staging and its influence on the determination of neurovascular bundle sparing and disease prognosis in patients with localized prostate cancer.

To identify a subset of men with Gleason score (GS) 6 prostate cancer who are at high risk for upgrading/upstaging who should be recommended for multiparametric magnetic resonance imaging.

Between 1992 and 2017, a total of 3571 men with GS6 prostate cancer were consecutively treated at a single institution with radical prostatectomy.

Based on findings from transrectal ultrasound guided (TRUS) biopsies series, standard sampling of the prostate targets the posterior/peripheral zone. However, a substantial proportion of PCa suspicious MRI PI-RADS ≥3 lesions is located in the anterior segment of the prostate, requiring a deeper placement and targeting of the biopsy needle.

The role of multi-parametric (mp)MRI in the diagnosis and treatment of prostate cancer has increased considerably. An alternative to visual inspection of mpMRI is the evaluation using histogram-based (first order statistics) parameters and textural features (second order statistics).

The clinical pathway to detect and diagnose prostate cancer has been revolutionised by the use of multiparametric MRI (mpMRI pre-biopsy). mpMRI however remains a resource-intensive test and is highly operator dependent with variable effectiveness with regard to its negative predictive value.

Based on unfavorable oncological and functional outcomes of non-organ-confined (NOC) prostate cancer (PCa), defined as ≥ pT3, pN1 or both, we aimed to develop a NOC prediction tool based on multiparametric MRI-guided targeted fusion biopsy (TBx).

The aim of this study was to evaluate the detection rate for clinically significant prostate cancer (PCa) after multiparametric magnetic resonance imaging (mpMRI)/transrectal ultrasound (TRUS) fusion biopsy versus extended biopsy or saturation prostate biopsy (SPBx) in men enrolled on active surveillance (AS).

Multiparametric magnetic resonance imaging (mpMRI) is increasingly used in staging early prostate cancer (PCa) but remains heavily reader-dependent. We aim to define the incremental utility of mpMRI over clinical parameters in determining the pathologic extracapsular extension (pECE) of PCa interpreted in a standard radiologic setting and when further over-read by a specialized reader.

Multiparametric magnetic resonance imaging (mpMRI) is an evolving non-invasive imaging modality that increases the accurate localization of prostate cancer (PCa) at the time of MRI targeted biopsy, enhancing clinical risk assessment, and improving the ability to appropriately counsel patients regarding therapy.

To evaluate the ability of prostate-specific membrane antigen (PSMA)-positron-emission tomography (PET)/computed tomography (CT) to detect intermediate-grade intra-prostatic prostate cancer (PCa), and to determine if PSMA-PET improves the diagnostic accuracy of multiparametric magnetic resonance imaging (mpMRI).

To determine whether replacement of protocol-driven repeat prostate biopsy (PB) with multiparametric magnetic resonance imaging (mpMRI) +/- targeted repeat prostate biopsy (TB) in evaluating men on active surveillance (AS) for low-volume low- to intermediate-risk prostate cancer (PCa) altered the likelihood or time to treatment, or reduced the number of repeat biopsies required to trigger treatment.

To determine whether patients can avoid systematic prostate biopsy (PBx) if their Prostate Imaging Reporting and Data System version 2 (PI-RADs v2) score is ≤ 3 and how we clinicians make decisions that can maximize benefit.

This report presents our early experience at Cleveland Clinic replacing conventional ultrasound with a novel 29 MHz high-resolution micro-ultrasound system for both systematic sampling and real-time targeting of suspicious regions during prostate biopsy.

The purpose of this study was to determine whether 5α-reductase inhibitors (5-ARIs) affect the discrimination between low-grade prostate cancer and benign tissues on multiparametric MRI (mpMRI).

To evaluate the integration of 3T non-endorectal-coil multiparametric prostate MRI (mpMRI) at two high-volume practices that routinely use mpMRI in the setting of active surveillance.

This was an IRB-approved, HIPAA-compliant, dual-institution retrospective cohort study.

68Ga-prostate-specific membrane antigen (PSMA)-11 PET/CT represents an advanced method for the staging of primary prostate cancer (PCa) and diagnosis of recurrent or metastatic PCa. However, because of the narrow availability of 68Ga the development of alternative tracers is of high interest.

Diffusion-weighted imaging (DWI) is the most effective component of the modern multi-parametric magnetic resonance imaging (mpMRI) scan for prostate pathology. DWI provides the strongest prediction of cancer volume, and the apparent diffusion coefficient (ADC) correlates moderately with Gleason grade.

The anatomy of the prostate is reviewed in the context of discussing the staging of prostate cancer and patterns of tumor spread. The utility of prostate magnetic resonance imaging along with new advancements in tumor staging are discussed specifically in locally advanced disease.

Multiparametric magnetic resonance imaging (mpMRI) of the prostate has become integral in the investigation of suspected prostate cancer. Regions of interest are graded using the PIRADS scoring system, and in our institution, lesions graded as PIRADS 3-5 undergo sampling by MRI-guided biopsy.

To analyze the number of mpMRI targeted biopsy (TBx) cores per lesion needed for PCa detection in patients treated with radical prostatectomy (RP).

Analyses focus on TBx of PCa suspicious MRI lesions (PI-RADS ≥3) with consecutive RP.

There is increasing evidence to implement multiparametric magnetic resonance imaging (mpMRI) for biopsy-naive men with clinically suspected prostate cancer (PCa). This will reduce the number of unnecessary trans rectal ultrasound biopsies (TRUS-Bx) performed and reduce the number of indolent cancers diagnosed.

Introduction: MRI-targeted biopsy (TB) increases overall prostate-cancer (PCa) detection-rates and decreases the risk of insignificant PCa detection. However, the impact of these findings on the definite pathology after radical prostatectomy (RP) is under debate.

This study aimed to test high temporal resolution dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for different zones of the prostate and evaluate its performance in the diagnosis of prostate cancer (PCa).

Much criticism has been leveled at screening for prostate cancer using prostate-specific antigen (PSA) testing, yet there is no suitable replacement to improve the detection of clinically significant cancer (CSC).

To examine the performance of a primary MRI/ultrasound fusion guided targeted biopsy (TB) and in combination with an added systematic biopsy (SB).

Analysis of 318 consecutive biopsy naïve men with suspicious mpMRI (PI-RADS score ≥3) undergoing transrectal TB and 10-core systematic biopsy (SB) between January 2012 and December 2016.

To assess early outcomes since the introduction of an active surveillance (AS) protocol incorporating mpMRI guided baseline biopsies and image based surveillance.

A new AS protocol mandating image-guided baseline biopsies, annual mpMRI and 3 monthly PSA but which retained protocol re-biopsies was tested.

To compare the oncologic and functional outcomes of partial vs whole-gland cryotherapy for men with intermediate-risk prostate cancer.

Men with intermediate-risk prostate cancer treated with primary prostate cryotherapy from 1993 to 2013 were selected from the Cryo On-Line Data Registry for a 1:1 matched comparison between those undergoing whole-gland and partial prostate cryotherapy (targeted ablation, unilateral/bilateral nerve-sparing ablations).

In this chapter the use of prostate specific antigen (PSA) as a tumor marker for prostate cancer is discussed. The chapter provides an overview of biological and clinical aspects of PSA. The main drawback of total PSA (tPSA) is its lack of specificity for prostate cancer which leads to unnecessary biopsies.

Prostate cancer is a common malignancy in men, but its management is fraught with controversy owing to its variable biologic and clinical behavior. Despite evidence that PSA screening reduces prostate cancer specific metastasis and death, it has not gained acceptance by various health authorities.

Prostate cancer is the second commonest cancer among men. In the large European Randomized Study of Screening for Prostate Cancer (ERSPC) trial, prostate-specific antigen (PSA) screening has been shown to substantially reduce prostate cancer mortality.

We assessed the difference in the detection rate of prostate cancer, specifically clinically significant prostate cancer, using targeted biopsy (TB), systematic biopsy (SB), and the combination of these 2 (CB) in biopsy-naive men with positive multiparameter magnetic resonance imaging results.

To assess the accuracy of multiparametric magnetic resonance imaging (mpMRI) for significant PC detection before diagnostic biopsy in men with abnormal PSA/DRE.

388 men underwent mpMRI including T2-weighted, diffusion-weighted & dynamic contrast-enhanced imaging prior to biopsy.

The current standard for Prostate Cancer (PCa) detection in biopsy-naïve men consists of 10-12 systematic biopsies under ultrasound guidance. This approach leads to underdiagnosis and undergrading of significant PCa while insignificant PCa may be overdiagnosed.

Local recurrent prostate cancer after radical treatment is found in the majority of men with a rising PSA. Salvage treatment procedures for recurrent disease, such as radiation therapy and ablative procedures, can provide long-term responses in well-selected cases.

With the long-standing controversy surrounding the use of prostate-specific antigen (PSA) for the detection, evaluation, and surveillance of prostate cancer, there is a need for a minimally invasive technique to identify and risk-stratify these patients.

To describe the use of a novel 'trizonal' biopsy schema in which 'near-target' biopsies are taken adjacent to the MRI lesion, in addition to target and systematic biopsies, to determine the accuracy of prostate MRI fusion systems.

To test whether using disease prognosis can inform a rational approach to Active Surveillance (AS) for early prostate cancer METHODS: We previously developed the Cambridge Prognostics Groups (CPG), a 5-tiered model that uses PSA, Grade Group and stage to predict cancer survival outcomes.

To assess if the adoption of multiparametric magnetic resonance imaging (mpMRI) in active surveillance (AS) has improved the identification of occult higher grade prostate cancer (PCa).

We retrospectively identified men from the Johns Hopkins AS registry enrolled since 2013 (year of mpMRI adoption) with Grade Group (GG) 1 PCa and underwent a single mpMRI.