OBJECTIVE • To evaluate the role of multiparametric magnetic resonance imaging (MRI) as an additional diagnostic tool for improving the accuracy of the urinary prostate cancer antigen 3 (PCA3) test in patients with an increase in prostate-specifi c antigen (PSA) levels and a previous negative prostate biopsy. PATIENTS AND METHODS • The present study comprised a prospective randomized study on patients with a previous negative transrectal ultrasonography (TRUS)-guided prostate biopsy and elevated PSA levels. • In total, 180 cases were analyzed, and all were submitted to PCA3 assay. • Patients in group A were submitted to a second random TRUS-guided prostate biopsy, whereas patients in group B were submitted to a multiparametric MRI examination and then to a second TRUS-guided prostate biopsy. RESULTS • At the second biopsy, a histological diagnosis of prostate cancer was found in 26 of 84 cases (30.9%) in group A and in 29 of 84 cases (34.5%) in group B. • In group A, the sensitivity and specifi city of the PCA3 score were 68.0% and 74.5% respectively (positive predictive value of 53.1%, negative predictive value of 84.6% and accuracy of 72.6%). • In group B, the sensitivity and specifi city of the PCA3 score were 79.3% and 72.7%, respectively (positive predictive value of 60.5%, negative predictive value of 86.9% and accuracy of 75.0%). • For the PCA3 score, the area under the receiver-operator characteristic curve was 0.825 (95% confi dence interval, 0.726 – 0.899) in group A and 0.857 (95% confi dence interval, 0.763 – 0.924) in group B ( P < 0.001). CONCLUSION • In patients with a previous negative biopsy and persistently elevated PSA levels, the use of multiparametric MRI for indicating sites suitable for rebiopsy can signifi cantly improve the sensitivity of the PCA3 test in the diagnosis of prostate cancer.
Multiparametric magnetic resonance imaging of the prostate can improve the predictive value of the urinary prostate cancer antigen 3 test in patients with elevated prostate-specific antigen levels and a previous negative biopsy
Busetto GIAN MARIA;
2012-01-01
Abstract
OBJECTIVE • To evaluate the role of multiparametric magnetic resonance imaging (MRI) as an additional diagnostic tool for improving the accuracy of the urinary prostate cancer antigen 3 (PCA3) test in patients with an increase in prostate-specifi c antigen (PSA) levels and a previous negative prostate biopsy. PATIENTS AND METHODS • The present study comprised a prospective randomized study on patients with a previous negative transrectal ultrasonography (TRUS)-guided prostate biopsy and elevated PSA levels. • In total, 180 cases were analyzed, and all were submitted to PCA3 assay. • Patients in group A were submitted to a second random TRUS-guided prostate biopsy, whereas patients in group B were submitted to a multiparametric MRI examination and then to a second TRUS-guided prostate biopsy. RESULTS • At the second biopsy, a histological diagnosis of prostate cancer was found in 26 of 84 cases (30.9%) in group A and in 29 of 84 cases (34.5%) in group B. • In group A, the sensitivity and specifi city of the PCA3 score were 68.0% and 74.5% respectively (positive predictive value of 53.1%, negative predictive value of 84.6% and accuracy of 72.6%). • In group B, the sensitivity and specifi city of the PCA3 score were 79.3% and 72.7%, respectively (positive predictive value of 60.5%, negative predictive value of 86.9% and accuracy of 75.0%). • For the PCA3 score, the area under the receiver-operator characteristic curve was 0.825 (95% confi dence interval, 0.726 – 0.899) in group A and 0.857 (95% confi dence interval, 0.763 – 0.924) in group B ( P < 0.001). CONCLUSION • In patients with a previous negative biopsy and persistently elevated PSA levels, the use of multiparametric MRI for indicating sites suitable for rebiopsy can signifi cantly improve the sensitivity of the PCA3 test in the diagnosis of prostate cancer.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
