Acta Oncol Tur.. 2022; 55(1): 9-15 | DOI: 10.5505/aot.2022.59140

Diagnostic Value of 1.5 Tesla Multiparametric MRI in Prostate Cancer

Ülkü Bekar, Þehnaz Tezcan
Koru Hospital, Radiology Department, Ankara, Turkey

INTRODUCTION: Although prostate biopsy is still the gold standard in diagnosis of prostate cancer (PC), multi-parametric MRI (MpMRI) applied with 1.5 Tesla (T) or 3T systems has become an indispensable method in diagnosis. We aimed to compare “Prostate Imaging-Reporting and Data System version2” (PI-RADSv2) scores with pathology of patients who underwent MpMRG (1.5T) for the suspicion of PC.

METHODS: Between January 2017 and January 2020, 52 patients (26 benign, 26 malignant patients) who underwent MpMRI followed by biopsy in our center due to suspicion of PC were included in our study. Age, prostate volume, blood PSA (prostate specific antigen) value, density and pathology of these cases were analyzed. The PI-RADSv2 assessment category was assigned for each patient by an experienced radiologist. The "Chi-square" test and "Student-t" test were used for statistical analysis.
RESULTS: The mean prostate volume of benign group (96.4±77.7) was significantly higher than patients with cancer (47.4±17.3) (p=0.003). Mean PSA value and PSA density in patients with malignancy (PSA value, 13.7±16.5 ng/ml; PSA density, 0.33±0.46 ng/ml/cc) were significantly higher than benign group (PSA value, 6.8±3.3 ng/ml; PSA density, 0.09±0.05 ng/ml/cc, p<0,05). The sensitivity, specificity, negative predictive value and positive predictive value of MpMRI applied with 1.5 T system in detection of significant PC was 73.08% 84.62%, 82.61% and 75.86%, respectively.

DISCUSSION AND CONCLUSION: Considering the high negative predictive value of negative MpMRI findings for significant PC due to PI-RADSv2, MRI can reduce unnecessary biopsy.

Keywords: Multiparametric magnetic resonance imaging, prostate biopsy, prostate cancer, Prostate Imaging–Reporting and Data System

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1.5 Tesla Multiparametrik MRG’nin Prostat Kanserinde Tanýsal Deðeri

Ülkü Bekar, Þehnaz Tezcan
Koru Hastanesi, Radyoloji Ana Bilim Dalý, Ankara, Türkiye

GÝRÝÞ ve AMAÇ: Prostat kanseri tanýsýnda prostat biyopsisi halen altýn standart tetkik olmakla birlikte 1,5 Tesla (T) ya da 3 T cihazlarla uygulanan multi-parametrik MRG (MpMRG), tanýda vazgeçilmez bir tetkik haline gelmiþtir. Bu çalýþmada; prostat kanseri þüphesiyle 1,5 T cihaz ile MpMRG yapýlan hastalarýn, Prostat Görüntüleme Raporlama ve Bilgi Sistemi versiyon2 (PI-RADSv2) skorlarýný, prostat biyopsisi patoloji sonuçlarýyla karþýlaþtýrmayý amaçladýk.

YÖNTEM ve GEREÇLER: Çalýþmamýza kliniðimizde Ocak 2017-Ocak 2020 tarihleri arasýnda prostat kanser þüphesi nedeniyle MpMRG ve ardýndan prostat biyopsisi yapýlmýþ 52 hasta (26 benign, 26 malign) dahil edildi. Bu olgularýn yaþý, prostat hacmi, kan PSA (prostat spesifik antijen) deðeri, yoðunluðu ve patoloji sonuçlarý analiz edildi. Deneyimli bir radyolog tarafýndan her bir hasta için PI-RADSv2 skorlama sistemine göre kategorizasyon yapýldý. Ýstatistiksel analizde “Ki kare” testi ile “Student-t” test kullanýldý.

BULGULAR: Benign hasta grubunun (96,4±77,7) ortalama prostat hacmi malign gruptan (47,4±17.3) anlamlý olarak daha yüksektir (p=0,003). Ortalama PSA deðeri ve yoðunluðu malign hastalarda (PSA deðeri, 13,7±16,5 ng/ml; PSA yoðunluðu, 0,33±0,46 ng/ml/cc) benign hasta grubundan (PSA deðeri, 6,8±3,3 ng/ml; PSA yoðunluðu, 0,09±0,05 ng/ml/cc; p<0,05) daha yüksektir. 1,5T cihaz ile uygulanan MpMRG’nin anlamlý prostat kanseri saptamadaki sensitivitesi %73,08, spesifitesi %84,62 pozitif prediktif deðeri %82,61 iken negatif prediktif deðeri ise %75,86 olarak hesaplandý.

TARTIÞMA ve SONUÇ: PI-RADSv2’ye göre negatif MpMRG’nin yüksek negatif prediktif deðeri göz önüne alýndýðýnda MRG gereksiz biyopsi oranýný azaltabilir.

Anahtar Kelimeler: Multi-parametrik manyetik rezonans görüntüleme, prostat biyopsisi, prostat kanseri, Prostat Görüntüleme Raporlama ve Bilgi Sistemi versiyon2

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