title: Value of prostate multiparametric magnetic resonance imaging for predicting biopsy results in first or repeat biopsy.
abstract: OBJECTIVE
  To assess multiparametric magnetic resonance imaging (mp-MRI) in predicting prostate biopsy results.
  
  
  METHODS
  Patients who underwent mp-MRI prior to prostate biopsy were prospectively included. The prostate was subdivided into 14 sectors and mp-MRI findings assessed using a five-level subjective suspicion score (SSS). Biopsy included targeted samples of abnormal sectors and systematic samples of normal peripheral zone sectors.
  
  
  RESULTS
  Two hundred and eighty-eight patients were included [153 biopsy naïve, 135 with negative (n = 51) or positive (n = 84) prior biopsy]. Biopsy was positive in 168 patients. mp-MRI area under the receiver operating characteristic (ROC) curve (AUC) was 69.1% (95% CI: 67.1-70.9%), 72.5% (95% CI: 69.5-76%), and 73.8% (95% CI: 68.3-79.3%) at per sector, per lobe, and per patient analysis, respectively. At the per sector level, the AUC was significantly larger if detection was limited to cancers with a Gleason score of ≥7 (72.6%; 95% CI: 69.8-75.8%; p < 0.01) or ≥8 (87.1%; 95% CI: 78.3-95.7%; p < 0.01). mp-MRI performance was significantly influenced by prostate volume (p = 0.02), the presence of a concordant hypoechoic area (p < 0.001), but not by prostate-specific antigen (PSA) value, status of prior biopsy, or radiologists' experience. SSS was significantly associated with the Gleason score in true-positive lobes and patients (p < 0.0001). Using a SSS threshold of ≥3, cancer was missed in 13/102 lobes and 4/72 patients with cancers of Gleason score ≥7.
  
  
  CONCLUSIONS
  mp-MRI provides a good detection of cancers with a Gleason score of ≥7 in candidates suitable for prostate biopsy.
authors: Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon F-69437, France.
authors: H
authors: H
authors: Habchi
authors: Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon F-69437, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon F-69003, France; Inserm, U1032, LabTau, Lyon F-69003, France.
authors: F
authors: F
authors: Bratan
authors: Hospices Civils de Lyon, Department of Biostatistics, Lyon F-69003, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, Villeurbanne F-69622, France.
authors: A
authors: A
authors: Paye
authors: Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon F-69437, France.
authors: G
authors: G
authors: Pagnoux
authors: Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon F-69437, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon F-69003, France; Inserm, U1032, LabTau, Lyon F-69003, France.
authors: T
authors: T
authors: Sanzalone
authors: Hospices Civils de Lyon, Department of Pathology, Hôpital Edouard Herriot, Lyon F-69437, France.
authors: F
authors: F
authors: Mège-Lechevallier
authors: Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon F-69437, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon F-69003, France.
authors: S
authors: S
authors: Crouzet
authors: Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon F-69437, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon F-69003, France.
authors: M
authors: M
authors: Colombel
authors: Hospices Civils de Lyon, Department of Biostatistics, Lyon F-69003, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, Villeurbanne F-69622, France.
authors: M
authors: M
authors: Rabilloud
authors: Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon F-69437, France; Université de Lyon, Université Lyon 1, faculté de médecine Lyon Est, Lyon F-69003, France; Inserm, U1032, LabTau, Lyon F-69003, France. Electronic address: Olivier.rouviere@netcourrier.com.
authors: O
authors: O
authors: Rouvière
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*