Diagnostic accuracy of MRI scanning

Published Date: 19th July 2016

Publication Authors: McCabe JE

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Introduction and Objectives

To assess the accuracy of pre-biopsy MRI in detecting prostate cancer prior totransperineal template guided sector (TPTS) prostate biopsies.

Materials and Methods

Patients undergoing TPTS biopsy for diagnostic purposes (previous negative TRUS biopsies with persisting clinical suspicion of prostate cancer) were included in this prospective analysis. Patients underwent a pre-biopsy 1.5T diffusion weighted (DW) MRI scan. A 24-32 core transperineal biopsy was then undertaken from 6-8 anatomical sectors dependent upon prostate volume.

Results

A total of 106 patients were identified with a mean age 63.9 (range 29-80). Mean PSA and prostate volume was 10.7 (3.8-66.1) and 59.8 (20-140) respectively. Mean number of previous TRUS biopsies was 1 (0-4). Sensitivity of 1.5T DW MRI for prostate cancer diagnosis in this series was 58% with a specificity of 57%. A sub analysis of those with intermediate or high risk disease revealed a sensitivity of MRI of 58%.

Conclusion

With increased attention being focused on the reliability of MRI in prostate cancer diagnostics, this study serves as a timely reminder of the limitations of standard techniques. It remains to be seen whether newer MRI techniques and Tesla strengths will improve specificity in particular.

Abusanad, O; Iskander, M; Patrick, N; McCabe, J. (2014).  Diagnostic accuracy of MRI scanning in predicting tumour detection at transperineal template guided sector biopsy . Urology. 2014 (4 Supplement), S235

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