TY  - EJOU
AU  - Dianat, Seyed Saeid 
AU  - Carter, H. Ballentine 
AU  - Schaeffer, Edward M. 
AU  - Hamper, Ulrike M. 
AU  - Epstein, Jonathan I. 
AU  - Macura, Katarzyna J. 

TI  - Association of quantitative magnetic resonance imaging parameters with histological fndings from MRI/ultrasound fusion prostate biopsy
T2  - Canadian Journal of Urology

PY  - 2015
VL  - 22
IS  - 5
SN  - 1488-5581

AB  - <b>Introduction:</b> Purpose of this pilot study was to correlate quantitative parameters derived from the multiparametric magnetic resonance imaging (MP-MRI) of the prostate with results from MRI guided transrectal ultrasound (MRI/TRUS) fusion prostate biopsy in men with suspected prostate cancer.<br/>

<b>Materials and methods:</b> Thirty-nine consecutive patients who had 3.0T MP-MRI and subsequent MRI/TRUS fusion prostate biopsy were included and 73 MRI-identified targets were sampled by 177 cores. The pre-biopsy MP-MRI consisted of T2-weighted, diffusion weighted (DWI), and dynamic contrast enhanced (DCE) images. The association of quantitative MRI measurements with biopsy histopathology findings was assessed by Mann-Whitney U-test and Kruskal-Wallis test.<br/>

<b>Results:</b> Of 73 targets, biopsy showed benign prostate tissue in 46 (63%), cancer in 23 (31.5%), and atypia/high grade prostatic intraepithelial neoplasia in four (5.5%) targets. The median volume of cancer-positive targets was 1.3 cm³. The cancer-positive targets were located in the peripheral zone (56.5%), transition zone (39.1%), and seminal vesicle (4.3%). Nine of 23 (39.1%) cancer-positive targets were higher grade cancer (Gleason grade >6). Higher grade targets and cancer-positive targets compared to benign lesions exhibited lower mean apparent diffusion coefficient (ADC) value (952.7 < 1167.9 < 1278.9), and lower minimal extracellular volume fraction (ECF) (0.13 < 0.185 < 0.213), respectively. The difference in parameters was more pronounced between higher grade cancer and benign lesions.<br/>

<b>Conclusions:</b> Our findings from a pilot study indicate that quantitative MRI parameters can predict malignant histology on MRI/TRUS fusion prostate biopsy, which is a valuable technique to ensure adequate sampling of MRI-visible suspicious lesions under TRUS guidance and may impact patient management. The DWI-based quantitative measurement exhibits a stronger association with biopsy findings than the other MRI parameters.
KW  - prostate cancer
KW  -  multiparametric MRI
KW  -  ultrasonography
KW  -  biopsy

DO  -