title: In-Bore 3-T MR-guided Transrectal Targeted Prostate Biopsy: Prostate Imaging Reporting and Data System Version 2-based Diagnostic Performance for Detection of Prostate Cancer.
abstract: Purpose To determine the diagnostic yield of in-bore 3-T magnetic resonance (MR) imaging-guided prostate biopsy and stratify performance according to Prostate Imaging Reporting and Data System (PI-RADS) versions 1 and 2. Materials and Methods This study was HIPAA compliant and institution review board approved. In-bore 3-T MR-guided prostate biopsy was performed in 134 targets in 106 men who (a) had not previously undergone prostate biopsy, (b) had prior negative biopsy findings with increased prostate-specific antigen (PSA) level, or (c) had a prior history of prostate cancer with increasing PSA level. Clinical, diagnostic 3-T MR imaging was performed with in-bore guided prostate biopsy, and pathology data were collected. The diagnostic yields of MR-guided biopsy per patient and target were analyzed, and differences between biopsy targets with negative and positive findings were determined. Results of logistic regression and areas under the curve were compared between PI-RADS versions 1 and 2. Results Prostate cancer was detected in 63 of 106 patients (59.4%) and in 72 of 134 targets (53.7%) with 3-T MR imaging. Forty-nine of 72 targets (68.0%) had clinically significant cancer (Gleason score ≥ 7). One complication occurred (urosepsis, 0.9%). Patients who had positive target findings had lower apparent diffusion coefficient values (875 × 10-6mm2/sec vs 1111 × 10-6mm2/sec, respectively; P < .01), smaller prostate volume (47.2 cm3vs 75.4 cm3, respectively; P < .01), higher PSA density (0.16 vs 0.10, respectively; P < .01), and higher proportion of PI-RADS version 2 category 3-5 scores when compared with patients with negative target findings. MR targets with PI-RADS version 2 category 2, 3, 4, and 5 scores had a positive diagnostic yield of three of 23 (13.0%), six of 31 (19.4%), 39 of 50 (78.0%), and 24 of 29 (82.8%) targets, respectively. No differences were detected in areas under the curve for PI-RADS version 2 versus 1. Conclusion In-bore 3-T MR-guided biopsy is safe and effective for prostate cancer diagnosis when stratified according to PI-RADS versions 1 and 2.©RSNA, 2016.
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Nelly
authors.initials: N
authors.lastname: Tan
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Wei-Chan
authors.initials: WC
authors.lastname: Lin
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Pooria
authors.initials: P
authors.lastname: Khoshnoodi
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Nazanin H
authors.initials: NH
authors.lastname: Asvadi
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yoshida
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Daniel J A
authors.initials: DJ
authors.lastname: Margolis
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: David S K
authors.initials: DS
authors.lastname: Lu
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Holden
authors.initials: H
authors.lastname: Wu
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Kyung Hyun
authors.identifier: 0000-0003-4175-5322
authors.initials: KH
authors.lastname: Sung
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: David Y
authors.initials: DY
authors.lastname: Lu
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Jaioti
authors.initials: J
authors.lastname: Huang
authors.affiliation: From the UCLA Prostate Imaging Research Group, Department of Radiology (N.T., W.C.L., P.K., N.H.A., D.J.A.M., D.S.K.L., H.W., K.H.S., S.S.R.), and Department of Pathology (J.H., D.Y.L.), David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7473; Department of Radiology, Cathay General Hospital, Taipei, Taiwan (W.C.L.); School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (W.C.L.); and Department of Urologic Oncology, Hoag Family Cancer Institute, Hoag Hospital, Newport Beach, Calif (J.Y., D.Y.L.).
authors.forename: Steven S
authors.initials: SS
authors.lastname: Raman
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012372:ROC Curve; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D012189:Retrospective Studies