AwardsRSNA Country Presents Travel Award
It has recently been shown that an Abbreviated MRI Protocol is suitable for breast cancer screening. Aim of this study was to investigate whether an Abbreviated Prostate MRI protocol (AP-MRI), consisting of 2 pulse sequences only (high resolution T2-TSE and DWI in a single plane), acquired without endorectal coil, is sufficient to diagnose prostate cancer (PCa) in men presenting with elevated PSA-levels.METHOD AND MATERIALS
Ongoing prospective reader study on 222 men (mean age 53.6 years) with median PSA of 7.1 who underwent multiparametric 3.0T-MRI with multi-element surface coil. The AP-MRI took a table time of just under 10 min. The full diagnostic protocol (FDP) took 30 min and included the pulse sequences of the AP-MRI (0.4 mm in-plane axial T2-TSE and DWI with 4 b-values up to 1400 s/mm²), plus additional T2-TSE planes, coronal T1-TSE, and DCE. All MRI studies were read prospectively by two GU-radiologists in consensus according to PIRADS 2.0. Readers first read the AP-MR images and made their diagnoses. Then, they read the FDP. Results of MR-guided biopsy, TRUS/saturation biopsy, and/or final surgical pathology, or MRI and PSA follow up of at least 24 months served as SOR.RESULTS
PCa was finally diagnosed in 85/222 men (38.3%), with median size 12 mm, classified as Gleason-6 in 25 patients, Gln-7 in 31, Gln ≥ 8 in 29. Diagnostic indices of the AP-MRI vs. the FDP were: Sensitivity: 93% (79/85) vs. 94% (80/85); Specificity: 89% (122/137) vs. 87% (120/137); PPV: 84% (79/94) vs. 82% (80/97), NPV: 95% (122/128) vs. 96% (120/125). The single cancer that went undetected by AP-MRI was a Gln-6-cancer diagnosed by DCE. A total five additional cancers (Gln-6 in 3, and Gln-7 in 2 patients) went undetected by both, AP-MRI and FDP, and were detected by TRUS biopsy. NPV for biologically relevant prostate cancer (> Gln-6) was 98.8% (95%CI: 95.7%-99.9%) for both, AP-MRI and FDP.CONCLUSION
Abbreviated prostate MRI allows diagnosis of biologically relevant PCa in under 10 minutes magnet time, without endorectal coil and without contrast agent, and offers a diagnostic accuracy that is equivalent to that of a full state-of-the-art multi-parametric prostate MRI protocol.CLINICAL RELEVANCE/APPLICATION
Abbreviated prostate MRI, if confirmed by further studies, may open the door for systematic MRI screening for prostate cancer.