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Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):73-80

DOI: 10.23736/S2283-8376.17.00008-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: Italian

Role of multiparametric magnetic resonance sequences in characterization of suspected peripheral prostate lesions and PI-RADS 3 value

Eliodoro FAIELLA, Domiziana SANTUCCI , Federico GRECO, Giuseppina PACELLA, Bruno BEOMONTE ZOBEL, Rosario F. GRASSO

Dipartimento di Scienze Radiologiche, Università Campus Bio-Medico di Roma, Roma, Italia


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BACKGROUND: Evaluation of multi-parametric Magnetic Resonance (RMmp) sequences accurancy in the identification and characterization of suspected prostate cancer (CaP) lesions.
METHODS: We retrospectively evaluated 96 mp-MRI (1.5T) and 137 peripheral prostate lesions (ZP) suspected for CaP and analyzed by US/mpMRI fusion biopsy. Each examination included T2, DWI/ADC, post-contrast T1 (DCE) sequences, and spectroscopy (MRSI). Lesions were classified in accord to PI-RADS score version1; PI-RADS≥3 lesions were biopsied and, in case of malignancy, divided into five Gleason classes. Sensitivity, specificity, false positives and false negatives were evaluated for each sequence, including and excluding PI-RADS3 among positive lesions. ANOVA was performed to correlate PI-RADS with Gleason for each sequence. Rho Spearman test was performed to compare PI-RADS with histology (benign vs. malignant lesions) and with Gleason.
RESULTS: T2 and DWI sequences showed the best sensitivity (100% and 98%), both including and excluding PI-RADS3. The post-contrast and spectroscopic sequences showed the best specificity (97% and 100% excluding PI-RADS3 and 71% 98% including PI-RADS3). There was significant correlation between T2, DCE and MRSI (P<0.05) and Gleason. There was significant correlation between PI-RADS and histological outcome (P<0.01) for all sequences, and between PI-RADS and Gleason for T2 and MRSI (P<0.01) and DCE (P<0.05) sequences.
CONCLUSIONS: T2 and DWI/ADC sequences represent the best sequences in lesion identification (highest sensitivity). The lesions can be subsequently characterized by DCE and MRSI (highest specificity).


KEY WORDS: Magnetic resonance imaging - Prostate - Prostatic neoplasms

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