Ruolo della risonanza magnetica funzionale (DCE-MRI, DWI-MRI)in pazienti sottoposti a saturation biopsy per persistente sospetto di carcinoma prostatico nonostante un primo set bioptico negativo: risultati preliminari su esperienza monocentrica

Translated title of the contribution: [Autom. eng. transl.] Role of functional magnetic resonance imaging (DCE-MRI, DWI-MRI) in patients undergoing saturation biopsy for persistent suspicion of prostate cancer despite a first negative biopsy set: preliminary results on monocentric experience

Emilio Sacco, Francesco Sasso, Francesco Pierconti, Pierfrancesco Bassi, Anna Lia Valentini, Francesco Pinto, Angelo Totaro, Benedetta Gui, Alessandro Calarco, Gaetano Gulino, Lorenzo Bonomo, Giuseppe Palermo

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] Objectives The primary objective of the study is to verify whether in hypointense areas in T2 sequences weighted with morphological magnetic resonance imaging (MRI), dynamic perfusion imaging (DCE) with the wash-in rate (WR) and diffusion (DWI) parameters by means of the apparent diffusion coefficient (ADC) value are able to differentiate neoplastic formations (CaP) from non-neoplastic ones. The secondary objective is to identify a cut-off for WR and ADC values useful for identifying CaP. Materials and methods 20 patients with persistent suspicion of prostate cancer (persistently altered PSA), after a first negative biopsy set, underwent DCE-MRI and DWI-MRI immediately before repeating a saturated biopsy. MRI was performed with an endorectal coil associated with a phased array pelvic coil. The DWI exam was performed at 0-600 b-values. Fast SPGR-3D sequences were used for the administration of gadolinium for DCE-RMI. WR and ADC values were calculated in each suspected hypointense area on T2-weighted images. 24 samples were taken including the transition zone + 2 additional samples for each site suspected of functional MRI from a single urologist (AT), after discussion of the case with the radiologist who had performed the MRI examination. The reference standard was the histological examination of the biopsy performed by a single pathologist (FP). The student's T-test and receiver operating characteristic curves (ROC) were used for statistical analysis (p <0.05 was considered significant). Results 77 suspected hypointense lesions were detected in T2 dependent images. The WR values were significantly different (p <0.00001) in the areas with CaP compared to the non-CaP areas which were always of the atrophic or inflammatory type. For WR, the 4.377 cut-off showed sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV) in the identification of CaP equal to 74.2%, 100%, 89.6% and 100% respectively. In contrast, the PCA ADC values were not significantly different from those observed in non-neoplastic lesions (p = 0.07). Conclusions The WR parameter was reliable in the identification of CaP in the hypointense areas in T2, while the ADC did not seem able to differentiate the inflammatory and atrophic areas from the neoplastic ones.
Translated title of the contribution[Autom. eng. transl.] Role of functional magnetic resonance imaging (DCE-MRI, DWI-MRI) in patients undergoing saturation biopsy for persistent suspicion of prostate cancer despite a first negative biopsy set: preliminary results on monocentric experience
Original languageItalian
Title of host publicationLibro abstract dell' 84° congresso SIU, 23 - 26 Ottobre 2011, Roma
Pages156
Number of pages1
Publication statusPublished - 2011
Event84° congresso SIU - Roma
Duration: 23 Oct 201126 Oct 2011

Conference

Conference84° congresso SIU
CityRoma
Period23/10/1126/10/11

Keywords

  • RISONANZA MAGNETICA
  • TUMORE PROSTATA

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