D'Amico risk stratification correlates with degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging.
OBJECTIVE
We determined whether there is a correlation between D'Amico risk stratification and the degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging based on targeted biopsies done with our electromagnetically tracked magnetic resonance imaging/ultrasound fusion platform.


METHODS
A total of 101 patients underwent 3 Tesla multiparametric magnetic resonance imaging of the prostate, consisting of T2, dynamic contrast enhanced, diffusion weighted and spectroscopy images in cases suspicious for or with a diagnosis of prostate cancer. All prostate magnetic resonance imaging lesions were then identified and graded by the number of positive modalities, including low-2 or fewer, moderate-3 and high-4 showing suspicion on multiparametric magnetic resonance imaging. The biopsy protocol included standard 12-core biopsy, followed by real-time magnetic resonance imaging/ultrasound fusion targeted biopsies of the suspicious magnetic resonance lesions. Cases and lesions were stratified by the D'Amico risk stratification.


RESULTS
In this screening population 90.1% of men had a negative digital rectal examination. Mean±SD age was 62.7±8.3 years and median prostate specific antigen was 5.8 ng/ml. Of the cases 54.5% were positive for cancer on protocol biopsy. Chi-square analysis revealed a statistically significant correlation between magnetic resonance suspicion and D'Amico risk stratification (p<0.0001). Within cluster resampling demonstrated a statistically significant correlation between magnetic resonance suspicion and D'Amico risk stratification for magnetic resonance targeted core biopsies and magnetic resonance lesions (p<0.01)


CONCLUSIONS
Our data support the notion that using multiparametric magnetic resonance prostate imaging one may assess the degree of risk associated with magnetic resonance visible lesions in the prostate.
Urologic Oncology Branch, Molecular Imaging Program, National Cancer Institute, Department of Radiology and Imaging Sciences, National Institutes of Health and Center for Interventional Oncology, Bethesda, Maryland 20892-1107, USA.
Ardeshir R
AR
Rastinehad
Angelo A
AA
Baccala
Paul H
PH
Chung
Juan M
JM
Proano
Jochen
J
Kruecker
Sheng
S
Xu
Julia K
JK
Locklin
Baris
B
Turkbey
Joanna
J
Shih
Gennady
G
Bratslavsky
W Marston
WM
Linehan
Neil D
ND
Glossop
Pingkun
P
Yan
Samuel
S
Kadoury
Peter L
PL
Choyke
Bradford J
BJ
Wood
Peter A
PA
Pinto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods
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