MP18-16: Biparametric MRI Performance is Comparable to Multiparametric MRI for the Accurate Detection of Clinically Significant Prostate Cancer

MP18-16: Biparametric MRI Performance is Comparable to Multiparametric MRI for the Accurate Detection of Clinically Significant Prostate Cancer

Friday, May 3, 2024 3:30 PM to 5:30 PM · 2 hr. (US/Central)
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Abstract

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Full Abstract and Figures

Author Block

Nicholas A Pickersgill*, Saint Louis, MO, Alex L Shiang, Los Angeles, United Arab Emirates, Joel M Vetter, Nimrod Barashi, John Sheng, Joseph E Ippolito, Eric H Kim, Saint Louis, MO

Introduction

Multiparametric magnetic resonance imaging (MRI) is the most widely used approach for prostate MRI. While biparametric MRI (BP-MRI) involves shorter acquisition time and decreased cost, its diagnostic accuracy compared to multiparametric MRI (MP-MRI) is not well known. We aim to compare the accurate detection of clinically significant prostate cancer with BP-MRI and MP-MRI prior to biopsy.

Methods

A single-institution retrospective analysis was performed of men who underwent prostate MP-MRI and BP-MRI prior to biopsy between January 2019 and December 2022, interpreted by a single expert radiologist. All patients underwent systematic and targeted transperineal prostate biopsy after MRI. Receiver operating characteristic (ROC) curves were generated to assess the accuracy, sensitivity, and specificity of MP-MRI and BP-MRI using biopsy pathology with Grade Group =2 disease as the reference standard.

Results

In a cohort of 310 patients, 192 underwent MP-MRI and 118 underwent BP-MRI. Suspicious lesions were identified on 63.0% and 46.6% of MP-MRI and BP-MRI, respectively. Area under the curve values for MP-MRI and BP-MRI were 0.75 and 0.80, respectively (p=0.359). Diagnostic accuracy was 67.7% for MP-MRI and 74.6% for BP-MRI (p=0.199). Multivariate analysis revealed no difference in the likelihood of detecting Grade Group =2 disease on biopsy following either approach (OR 0.88 [0.53-1.45]).

Conclusions

BP-MRI and MP-MRI protocols demonstrated comparable predictive accuracy for the detection of clinically significant prostate cancer, suggesting that dynamic contrast enhancement offers limited clinical benefit. BP-MRI should be considered the standard for pre-biopsy imaging in patients with suspected prostate cancer.

Source Of Funding

None.

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