Document Detail


Inapparent Tumor on Endorectal Multimodality Magnetic Resonance Imaging of Prostate: Should We Perform a Biopsy?
MedLine Citation:
PMID:  21333339     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To examine whether one could spare patients with a clinical suspicion of prostate cancer (PCa) but inapparent tumor on multimodality endorectal magnetic resonance imaging (e-MRI) of the prostate from undergoing prostate biopsy. METHODS: A total of 109 patients with a clinical suspicion of PCa underwent conventional and functional e-MRI of the prostate and subsequently prostate biopsy. The inclusion criteria were prostate-specific antigen level >4 ng/mL or a suspicious finding on digital rectal examination. The images were interpreted by a highly experienced radiologist and were considered negative for PCa in all cases. Regardless of the negative findings, all patients underwent an 18-core prostate biopsy. Functional e-MRI included contrast-enhanced e-MRI and diffusion-weighted imaging. The examinations were performed on a closed 1.0-T system combined with an endorectal body phased-array coil. The clinicopathologic parameters of the patients included age, prostate-specific antigen level, digital rectal examination findings, PCa detection rate, clinically significant PCa detection rate, high-grade PCa detection rate, and e-MRI specificity. RESULTS: The median age of the patients was 67.4 years, and the median prostate-specific antigen level was 12.9 ng/mL. The digital rectal examination findings were positive in 42 patients (38.5%) and negative in 67 patients (61.5%). Overall, PCa was detected in 19.2% of patients, with 47.6% cases defined as clinically significant and 38.1% as high grade. Overall, the e-MRI specificity was 80.8%. CONCLUSIONS: The results of our study have shown that the absence of tumor on e-MRI scans of patients with a clinical suspicion of PCa does not rule out the probability of clinically significant and high-grade PCa, making prostate biopsy mandatory for these patients as well.
Authors:
Apostolos P Labanaris; Karl Engelhard; Vahudin Zugor; Jorn H Witt; Reinhard Kühn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-16
Journal Detail:
Title:  Urology     Volume:  -     ISSN:  1527-9995     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology and Pediatric Urology, Prostate Center Northwest, St. Antonius Medical Center, Gronau, Germany.
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