Abstract
Purpose
To compare and analyse the diagnostic value of PI-RADS v2.1 when used with biparametric MRI (bpMRI) versus multiparametric MRI (mpMRI), DWI versus T2WI to detect peripheral-zone prostate cancer (pzPCa) and clinically significant peripheral-zone prostate cancer (cs-pzPCa).
Methods
The diagnostic efficiencies of mpMRI and bpMRI as well as DWI and T2WI in pzPCa and cs-pzPCa were compared using a PI-RADS score of ≥ 4 as the positive threshold and prostate biopsy and radical prostatectomy as the reference standards.
Results
A total of 307 prostate cases were included in the study, including 142 in the non-pzPCa group, 165 in the pzPCa group, and 130 in the cs-pzPCa group. The AUCs of mpMRI and bpMRI were 0.717 and 0.733 (P = 0.317), respectively, for the diagnosis of pzPCa (sensitivities: 89.1% and 81.8%; specificities: 54.2% and 64.8%, both P < 0.001) and 0.594 and 0.602 (P = 0.756), respectively, for the diagnosis of cs-pzPCa (sensitivities: 93.1% and 86.2%, P = 0.004; specificities: 25.7% and 34.3%, P = 0.250). The AUCs of DWI and T2WI were 0.733 and 0.749 (P = 0.308), respectively, for the diagnosis of pzPCa (sensitivities: 81.8% and 84.2%; specificities: 64.8% and 66.2%, both P > 0.05) and 0.602 and 0.581 (P = 0.371), respectively, for the diagnosis of cs-pzPCa (sensitivities: 86.2% and 87.7%; specificities: 34.3% and 28.6%, both P > 0.05).
Conclusion
mpMRI and bpMRI as well as DWI and T2WI using PI-RADS v2.1 exhibited similar diagnostic efficiency in pzPCa and cs-pzPCa.
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Abbreviations
- ADC:
-
Apparent diffusion coefficient
- AUC:
-
Area under curve
- bpMRI:
-
Bi-parametric MRI
- cs-pzPCa:
-
Clinically significant peripheral-zone prostate cancer
- DCE:
-
Dynamic contrast enhanced
- DWI:
-
Diffusion weighted imaging
- mpMRI:
-
Multi-parametric MRI
- NPV:
-
Negative predictive value
- PCa:
-
Prostate cancer
- PI-RADS:
-
Prostate Imaging Reporting and Data System
- PPV:
-
Positive predictive value
- PSA:
-
Prostate-specific antigen
- pzPCa:
-
Peripheral-zone prostate cancer
- ROC:
-
Receiver operating characteristic curve
- T2WI:
-
T2-weighted imaging
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Funding
This study has received funding by the National Natural Science Foundation of China (Grant No. 91859119), the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (Grant No. 2019XK320028), the National Natural Science Foundation of China (Grant No. 81901742), the Natural Science Foundation of Bei**g Municipality (Grant No. 7192176), the Central University Basic Scientific Research Business Expenses Special Funds (Grant No. 3332018022), the National Public Welfare Basic Scientific Research Project of Chinese Academy of Medical Sciences (Grant Nos. 2019PT320008 and 2018PT32003).
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JZ contributed to data acquisition, analysis and writing original draft preparation. LX and GZ was involved in statistical analysis and tables and figure generating. XB and XZ participated in the data measurement and summary. ZJ and YX contributed to method guidance and paper editing. HS and ZJ contributed to the idea design of the paper and the modification of the final draft.
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This study was conducted as per the Declaration of Helsinki. The approval to the protocol was done by our institutional Research Ethics Committee and each regulation was followed.
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Zhang, J., Xu, L., Zhang, G. et al. Comparison between biparametric and multiparametric MRI diagnosis strategy for prostate cancer in the peripheral zone using PI-RADS version 2.1. Abdom Radiol 47, 2905–2916 (2022). https://doi.org/10.1007/s00261-022-03553-x
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DOI: https://doi.org/10.1007/s00261-022-03553-x