Biparametric vs. Multiparametric MRI in the Detection of Cancer in Transperineal Targeted-Biopsy-Proven Peripheral Prostate Cancer Lesions Classified as PI-RADS Score 3 or 3+1: The Added Value of ADC Quantification

Bertelli, Elena and Vizzi, Michele and Marzi, Chiara and Pastacaldi, Sandro and Cinelli, Alberto and Legato, Martina and Ruzga, Ron and Bardazzi, Federico and Valoriani, Vittoria and Loverre, Francesco and Impagliazzo, Francesco and Cozzi, Diletta and Nardoni, Samuele and Facchiano, Davide and Serni, Sergio and Masieri, Lorenzo and Minervini, Andrea and Agostini, Simone and Miele, Vittorio (2024) Biparametric vs. Multiparametric MRI in the Detection of Cancer in Transperineal Targeted-Biopsy-Proven Peripheral Prostate Cancer Lesions Classified as PI-RADS Score 3 or 3+1: The Added Value of ADC Quantification. Diagnostics, 14 (15). p. 1608. ISSN 2075-4418

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Abstract

Background: Biparametric MRI (bpMRI) has an important role in the diagnosis of prostate cancer (PCa), by reducing the cost and duration of the procedure and adverse reactions. We assess the additional benefit of the ADC map in detecting prostate cancer (PCa). Additionally, we examine whether the ADC value correlates with the presence of clinically significant tumors (csPCa). Methods: 104 peripheral lesions classified as PI-RADS v2.1 score 3 or 3+1 at the mpMRI underwent transperineal MRI/US fusion-guided targeted biopsy. Results: The lesions were classified as PI-RADS 3 or 3+1; at histopathology, 30 were adenocarcinomas, 21 of which were classified as csPCa. The ADC threshold that maximized the Youden index in order to predict the presence of a tumor was 1103 (95% CI (990, 1243)), with a sensitivity of 0.8 and a specificity of 0.59; both values were greater than those found using the contrast medium, which were 0.5 and 0.54, respectively. Similar results were also found with csPCa, where the optimal ADC threshold was 1096 (95% CI (988, 1096)), with a sensitivity of 0.86 and specificity of 0.59, compared to 0.49 and 0.59 observed in the mpMRI. Conclusions: Our study confirms the possible use of a quantitative parameter (ADC value) in the risk stratification of csPCa, by reducing the number of biopsies and, therefore, the number of unwarranted diagnoses of PCa and the risk of overtreatment.

Item Type: Article
Subjects: Journal Eprints > Medical Science
Depositing User: Managing Editor
Date Deposited: 26 Jul 2024 08:56
Last Modified: 26 Jul 2024 08:56
URI: http://repository.journal4submission.com/id/eprint/3890

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