title: 3-T in-bore MR-guided prostate biopsy based on a scoring system for target lesions characterization.
abstract: BACKGROUND
  To estimate potential malignant lesions within the prostate gland, the usage of a scoring system has recently been proposed by a European consensus meeting.
  
  
  OBJECTIVE
  To prospectively investigate a scoring system for functional prostate magnetic resonance imaging (MRI) using in-bore MR-guided prostate biopsy at 3-T.
  
  
  METHODS
  Prostate MRI examinations of 59 patients (between February 2011 and May 2012) with no known prostate cancer, elevated prostate specific antigen (PSA) level, and unsuspicious digital rectal examination were included in the study. In each patient up to three lesions were defined and scored using a 5-point scoring system for each MR sequence (T2-weighted images, diffusion-weighted imaging, dynamic contrast-enhanced imaging). Following MRI-guided in-bore biopsy these lesions were correlated to the histopathological findings.
  
  
  RESULTS
  A total number of 144 lesions were defined in 59 patients. In 28 patients (51 lesions) MR-guided in-bore biopsy was positive for tumor (Gleason grade 6 or higher). A cut-off limit of 10 or more points in summation of the individual scores of all three sequences was used, leading to a 90% sensitivity, 63% specificity, 58% positive predictive value, and 92% negative predictive value.
  
  
  CONCLUSIONS
  A simple 5-point scoring system of functional prostate MRI achieves excellent sensitivity and moderate specificity for directing 3-T-guided prostate biopsy relative to the histopathological findings.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Dusseldorf, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Quentin
authors.forename: Lars
authors.initials: L
authors.lastname: Schimmöller
authors.forename: Christian
authors.initials: C
authors.lastname: Arsov
authors.forename: Robert
authors.initials: R
authors.lastname: Rabenalt
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Peter
authors.initials: P
authors.lastname: Albers
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000473:pathology*; D012107:Research Design; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen
keywords: 3-T MRI; Prostate cancer; in-bore MR-guided biopsy at 3-T; scoring