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European Radiology

Erschienen in:

08.05.2023 | Commentary

Are upgraded DCE-positive PI-RADS 3 lesions truly suspicious for clinically significant prostate cancer?

verfasst von: Patrick Asbach, Anwar R. Padhani

Erschienen in: European Radiology | Ausgabe 8/2023

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Excerpt

MRI has become a key element in the diagnostic pathway for prostate cancer detection. Due to the high negative predictive value, MRI can select patients who do not need a prostate biopsy because of a very low likelihood of clinically significant prostate cancer. This is important to reduce the overdiagnosis of clinically insignificant disease. The high sensitivity of prostate MRI for the detection of clinically significant prostate cancer allows the identification of patients who benefit from prostate biopsy. However, the specificity and positive predictive value (PPV) are intermediate and highly variable between readers, centres [1], and study reports [2]. This translates into unnecessary biopsy procedures and the harms of overdiagnoses. …

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Mazzone E, Stabile A, Pellegrino F et al (2020) Positive predictive value of prostate imaging reporting and data system version 2 for the detection of clinically significant prostate cancer: a systematic review and meta-analysis. Eur Urol Oncol 4:697–713. https://doi.org/10.1016/j.euo.2020.12.004CrossRefPubMed

Mottet N, van den Bergh RC, Briers E et al (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer—2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 79:243–262. https://doi.org/10.1016/j.eururo.2020.09.042CrossRefPubMed

Kasivisvanathan V, Rannikko AS, Borghi M et al (2018) MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 378:1767–1777. https://doi.org/10.1056/NEJMoa1801993CrossRefPubMedPubMedCentral

Rouvière O, Puech P, Renard-Penna R et al (2019) Use of prostate systematic and targeted biopsy based on multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study. Lancet Oncol 20(1):100–109. https://doi.org/10.1016/S1470-2045(18)30569-2

Messina E, Pecoraro M, Laschena L et al (2023) Low cancer yield in PI-RADS 3 upgraded to 4 by dynamic contrast-enhanced MRI: is it time to reconsider scoring categorization? Eur Radiol. https://doi.org/10.1007/s00330-023-09605-0CrossRefPubMed

Sigle A, Borkowetz A, von Hardenberg J et al (2023) Prediction of significant prostate cancer in equivocal magnetic resonance imaging lesions: a high-volume international multicenter study. Eur Urol Focus S2405-4569(23)00038-X. https://doi.org/10.1016/j.euf.2023.01.020

Pellegrino F, Tin AL, Martini A et al (2023) Prostate-specific antigen density cutoff of 0.15 ng/ml/cc to propose prostate biopsies to patients with negative magnetic resonance imaging: efficient threshold or legacy of the past? Eur Urol Focus 9(2):291–297. https://doi.org/10.1016/j.euf.2022.10.002

Schoots IG, Barentsz JO, Bittencourt LK et al (2021) PI-RADS Committee position on MRI without contrast medium in biopsy-naive men with suspected prostate cancer: narrative review. AJR Am J Roentgenol 216:3–19. https://doi.org/10.2214/AJR.20.24268CrossRefPubMed

10.

Brancato V, Aiello M, Basso L et al (2021) Evaluation of a multiparametric MRI radiomic-based approach for stratification of equivocal PI-RADS 3 and upgraded PI-RADS 4 prostatic lesions. Sci Rep 11:643. https://doi.org/10.1038/s41598-020-80749-5CrossRefPubMedPubMedCentral

Titel: Are upgraded DCE-positive PI-RADS 3 lesions truly suspicious for clinically significant prostate cancer?
verfasst von: Patrick Asbach
Anwar R. Padhani
Publikationsdatum: 08.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2023
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09711-z

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