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Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

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Abstract

We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, F-69437, France

    Alexandre Ben Cheikh, Nicolas Girouin, Denis Lyonnet & Olivier Rouvière

  2. Université de Lyon, Lyon, F-69003, France

    Alexandre Ben Cheikh, Nicolas Girouin, Denis Lyonnet & Olivier Rouvière

  3. Université de Lyon 1, faculté de médecine Lyon Nord, Lyon, F-69003, France

    Alexandre Ben Cheikh, Nicolas Girouin, Denis Lyonnet & Olivier Rouvière

  4. Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, F-69437, France

    Marc Colombel, Jean-Marie Maréchal & Albert Gelet

  5. Hospices Civils de Lyon, Department of Biostatistics, Lyon, F-69424, France

    Alvine Bissery & Muriel Rabilloud

  6. Université de Lyon 1, UMR CNRS 5558, Laboratoire Biostatistiques-Santé, Pierre-Bénite, F-69495, France

    Alvine Bissery & Muriel Rabilloud

  7. Inserm, U556, Lyon, F-69424, France

    Albert Gelet, Denis Lyonnet & Olivier Rouvière

  8. Department of Urinary and Vascular Radiology, Pavillon P Radio, Hôpital Edouard Herriot, 69437, Lyon Cedex 03, France

    Olivier Rouvière

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  1. Alexandre Ben Cheikh
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  2. Nicolas Girouin
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  3. Marc Colombel
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  8. Denis Lyonnet
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  9. Olivier Rouvière
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Correspondence to Olivier Rouvière.

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Cheikh, A.B., Girouin, N., Colombel, M. et al. Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy. Eur Radiol 19, 770–778 (2009). https://doi.org/10.1007/s00330-008-1190-8

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  • DOI: https://doi.org/10.1007/s00330-008-1190-8

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