title: Multiparametric MRI for prostate cancer detection: performance in patients with prostate-specific antigen values between 2.5 and 10 ng/mL.
abstract: OBJECTIVE
  To assess the diagnostic performance of multiparametric MRI (mpMRI), in the detection of prostate cancer, including morphologic sequences (mMRI), diffusion-weighted imaging (DWI), and MR spectroscopy (MRS). Combined morphological and functional MRI scoring systems was used for urological–radiological work-up of patients with a prostate-specific antigen (PSA) value ≤ 10 ng/mL.
  
  
  METHODS
  The study included 136 of 200 consecutive patients with PSA values between 2.5 and 4 ng/mL and an abnormal digital rectal examination (DRE), or patients with PSA values between 4 and 10 ng/mL, independently from DRE. Each patient provided informed consent to undergo at serum free/total PSA ratio (f/t PSA) assay, mMRI, MRS, DWI, and transrectal ultrasonography (TRUS) biopsy. The MRI datasets were scored singularly; then mMRI and DWI, mMRI and MRS data were combined in a coupled score, and finally mMRI, DWI, and MRS data were combined in a single score (cMRI score).
  
  
  RESULTS
  Scores were correlated to negative biopsies and significant/insignificant Gleason score biopsies. Receiver-operator-characteristic curve and McNemar tests were performed. Cancer was diagnosed in 18% of patients. The cMRI score showed: (i) the highest sensitivity (0.84) and negative predictive value (0.93); (ii) a significant correlation with Gleason score; and (iii) a statistically different median value between significant and insignificant Gleason score.
  
  
  CONCLUSIONS
  The cMRI score could identify patients with a PSA≤10 ng/mL who will have a negative work-up, for its high negative predictive value, and patients at high risk for significant prostate cancer because of its correlation with the Gleason score
authors.forename: Antonella
authors.initials: A
authors.lastname: Petrillo
authors.forename: Roberta
authors.initials: R
authors.lastname: Fusco
authors.forename: Sergio V
authors.initials: SV
authors.lastname: Setola
authors.forename: Francesco M
authors.initials: FM
authors.lastname: Ronza
authors.forename: Vincenza
authors.initials: V
authors.lastname: Granata
authors.forename: Mario
authors.initials: M
authors.lastname: Petrillo
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Carone
authors.forename: Mario
authors.initials: M
authors.lastname: Sansone
authors.forename: Renato
authors.initials: R
authors.lastname: Franco
authors.forename: Franco
authors.initials: F
authors.lastname: Fulciniti
authors.forename: Sisto
authors.initials: S
authors.lastname: Perdonà
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007610:Kallikreins / Q000097:blood*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen