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J Urol. 2011 Mar;185(3):815-20. doi: 10.1016/j.juro.2010.10.076. Epub 2011 Jan 15.

D'Amico risk stratification correlates with degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging.

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  • 1Urologic Oncology Branch, Molecular Imaging Program, National Cancer Institute, Department of Radiology and Imaging Sciences, National Institutes of Health and Center for Interventional Oncology, Bethesda, Maryland 20892-1107, USA.

Abstract

PURPOSE:

We determined whether there is a correlation between D'Amico risk stratification and the degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging based on targeted biopsies done with our electromagnetically tracked magnetic resonance imaging/ultrasound fusion platform.

MATERIALS AND METHODS:

A total of 101 patients underwent 3 Tesla multiparametric magnetic resonance imaging of the prostate, consisting of T2, dynamic contrast enhanced, diffusion weighted and spectroscopy images in cases suspicious for or with a diagnosis of prostate cancer. All prostate magnetic resonance imaging lesions were then identified and graded by the number of positive modalities, including low-2 or fewer, moderate-3 and high-4 showing suspicion on multiparametric magnetic resonance imaging. The biopsy protocol included standard 12-core biopsy, followed by real-time magnetic resonance imaging/ultrasound fusion targeted biopsies of the suspicious magnetic resonance lesions. Cases and lesions were stratified by the D'Amico risk stratification.

RESULTS:

In this screening population 90.1% of men had a negative digital rectal examination. Mean±SD age was 62.7±8.3 years and median prostate specific antigen was 5.8 ng/ml. Of the cases 54.5% were positive for cancer on protocol biopsy. Chi-square analysis revealed a statistically significant correlation between magnetic resonance suspicion and D'Amico risk stratification (p<0.0001). Within cluster resampling demonstrated a statistically significant correlation between magnetic resonance suspicion and D'Amico risk stratification for magnetic resonance targeted core biopsies and magnetic resonance lesions (p<0.01)

CONCLUSIONS:

Our data support the notion that using multiparametric magnetic resonance prostate imaging one may assess the degree of risk associated with magnetic resonance visible lesions in the prostate.

Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Comment in

  • Editorial comment. [J Urol. 2011]
PMID:
21239006
[PubMed - indexed for MEDLINE]
PMCID:
PMC3169005
Free PMC Article

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