title: Impact of delay after biopsy and post-biopsy haemorrhage on prostate cancer tumour detection using multi-parametric MRI: a multi-reader study.
abstract: OBJECTIVE
  To assess impact of haemorrhage and delay after biopsy on prostate tumour detection using multi-parametric (MP) magnetic resonance imaging (MRI) assessment.
  
  
  METHODS
  Forty-four patients underwent prostate MRI at 1.5 T using a pelvic phased-array coil, including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging, before prostatectomy. Three radiologists independently reviewed images during four sessions [T2WI, DWI, DCE, and all parameters combined (MP-MRI)] to assess for tumour in each sextant. In a separate session, readers reviewed T1WI to score the extent of haemorrhage per sextant. Accuracy was assessed using logistic regression for correlated data.
  
  
  RESULTS
  There was no significant difference in accuracy between readers for any session (p ≥ 0.166), and results were averaged across the three readers for remaining comparisons. Accuracy was significantly greater for MP-MRI than for any parameter alone (p ≤ 0.020). For T2WI alone, there was a trend toward decreased sensitivity in sextants with extensive haemorrhage (p = 0.072). However, accuracy, sensitivity, and specificity were otherwise similar for sextants with and without extensive haemorrhage for all sessions (p = 0.192-0.934). No session showed a significant improvement in accuracy, sensitivity, or specificity in cases with delay after biopsy of over 4 weeks compared with shorter delay.
  
  
  CONCLUSIONS
  Extensive haemorrhage and short delay after biopsy did not negatively impact accuracy for tumour detection using MP-MRI. Further studies using MP-MRI protocols and interpretation schemes from other institutions are required to confirm these observations.
authors.affiliation: Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA. Andrew.Rosenkrantz@nyumc.org
authors.forename: A B
authors.initials: AB
authors.lastname: Rosenkrantz
authors.forename: T C
authors.initials: TC
authors.lastname: Mussi
authors.forename: N
authors.initials: N
authors.lastname: Hindman
authors.forename: R P
authors.initials: RP
authors.lastname: Lim
authors.forename: M X
authors.initials: MX
authors.lastname: Kong
authors.forename: J S
authors.initials: JS
authors.lastname: Babb
authors.forename: J
authors.initials: J
authors.lastname: Melamed
authors.forename: S S
authors.initials: SS
authors.lastname: Taneja
mesh_terms: D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D003287:Contrast Media