title: Negative predictive value of multiparametric MRI for prostate cancer detection: outcome of 5-year follow-up in men with negative findings on initial MRI studies.
abstract: OBJECTIVE
  To assess the clinical negative predictive value (NPV) of multiparametric MRI (mp-MRI) for prostate cancer in a 5-year follow-up.
  
  
  METHODS
  One hundred ninety-three men suspected of harboring prostate cancer with negative MRI findings were included. Patients with positive transrectal ultrasound (TRUS)-guided biopsy findings were defined as false-negative. Patients with negative initial TRUS-guided biopsy findings were followed up and only patients with negative findings by digital rectal examination, MRI, and repeat biopsy and no increase in PSA at 5-year follow-up were defined as "clinically negative". The clinical NPV of mp-MRI was calculated. For quantitative analysis, mean signal intensity on T2-weighted images and the mean apparent diffusion coefficient value on ADC maps of the initial MRI studies were compared between peripheral-zone (PZ) cancer and the normal PZ based on pathologic maps of patients who had undergone radical prostatectomy.
  
  
  RESULTS
  The clinical NPV of mp-MRI was 89.6% for significant prostate cancer. Small cancers, prostatitis, and benign prostatic hypertrophy masking prostate cancer returned false-negative results. Quantitative analysis showed that there was no significant difference between PZ cancer and the normal PZ.
  
  
  CONCLUSIONS
  The mp-MRI revealed a high clinical NPV and is a useful tool to rule out clinically significant prostate cancer before biopsy.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan; Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan. Electronic address: banguliao@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Itatani
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Namimoto
authors.affiliation: Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Atsuji
authors.affiliation: Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Katahira
authors.affiliation: Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Morishita
authors.affiliation: Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kitani
authors.affiliation: Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: Department of Pathology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto 862-0965, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kitaoka
authors.affiliation: Department of Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto 863-0046, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakaura
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
keywords: Multiparametric MRI (mp-MRI); Negative predictive value; Prostate cancer