| Title: |
False Positive Multiparametric Magnetic Resonance Imaging Phenotypes in the Biopsy-naïve Prostate: Are They Distinct from Significant Cancer-associated Lesions? Lessons from PROMIS |
| Authors: |
Stavrinides, V; Syer, T; Hu, Y; Giganti, F; Freeman, A; Karapanagiotis, S; Bott, SRJ; Brown, LC; Burns-Cox, N; Dudderidge, TJ; Bosaily, AE-S; Frangou, E; Ghei, M; Henderson, A; Hindley, RG; Kaplan, RS; Oldroyd, R; Parker, C; Persad, R; Rosario, DJ; Shergill, IS; Echeverria, LMC; Norris, JM; Winkler, M; Barratt, D; Kirkham, A; Punwani, S; Whitaker, HC; Ahmed, HU; Emberton, M |
| Source: |
European Urology (2020) |
| Publisher Information: |
Elsevier BV |
| Publication Year: |
2020 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
False positive lesions; Multiparametric magnetic resonance imaging; PROMIS; Prostate cancer |
| Description: |
Background: False positive multiparametric magnetic resonance imaging (mpMRI) phenotypes prompt unnecessary biopsies. The Prostate MRI Imaging Study (PROMIS) provides a unique opportunity to explore such phenotypes in biopsy-naïve men with raised prostate-specific antigen (PSA) and suspected cancer. / Objective: To compare mpMRI lesions in men with/without significant cancer on transperineal mapping biopsy (TPM). / Design, setting, and participants: PROMIS participants (n = 235) underwent mpMRI followed by a combined biopsy procedure at University College London Hospital, including 5-mm TPM as the reference standard. Patients were divided into four mutually exclusive groups according to TPM findings: (1) no cancer, (2) insignificant cancer, (3) definition 2 significant cancer (Gleason ≥3 + 4 of any length and/or maximum cancer core length ≥4 mm of any grade), and (4) definition 1 significant cancer (Gleason ≥4 + 3 of any length and/or maximum cancer core length ≥6 mm of any grade). / Outcome measurements and statistical analysis: Index and/or additional lesions present in 178 participants were compared between TPM groups in terms of number, conspicuity, volume, location, and radiological characteristics. / Results and limitations: Most lesions were located in the peripheral zone. More men with significant cancer had two or more lesions than those without significant disease (67% vs 37%; p < 0.001). In the former group, index lesions were larger (mean volume 0.68 vs 0.50 ml; p < 0.001, Wilcoxon test), more conspicuous (Likert 4–5: 79% vs 22%; p < 0.001), and diffusion restricted (mean apparent diffusion coefficient [ADC]: 0.73 vs 0.86; p < 0.001, Wilcoxon test). In men with Likert 3 index lesions, log2PSA density and index lesion ADC were significant predictors of definition 1/2 disease in a logistic regression model (mean cross-validated area under the receiver-operator characteristic curve: 0.77 [95% confidence interval: 0.67–0.87]). / Conclusions: Significant cancer-associated MRI lesions in ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10112345/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10112345/1/1-s2.0-S0302283820307703-main.pdf; https://discovery.ucl.ac.uk/id/eprint/10112345/ |
| Rights: |
open |
| Accession Number: |
edsbas.14A80AE7 |
| Database: |
BASE |