Comparison between multiparametric MRI with and without post - contrast sequences for clinically significant prostate...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Dynamic-contrast enhanced (DCE) sequences aim to improve detection of small lesions via increased vascularization.
• The incremental value of DCE in detecting clinically significant prostate cancer (PCa) remains controversial.
• Absence of enhancement does not rule out cancer, and enhancement alone is not definitive for tumor identification.

Purpose of the Study:

• To evaluate if DCE MRI sequences enhance the detection of clinically significant prostate cancer (CS PCa) prior to biopsy.
• This study compared MRI exams with and without contrast sequences to assess their impact on CS PCa detection.
• The hypothesis tested was that DCE images do not increase CS PCa detection.

Main Methods:

• 102 men undergoing 3T MRI for prostate cancer evaluation were included.
• Reference standard involved transrectal ultrasound (TRUS) with systematic and MRI/US fusion biopsies.
• Radiologists prospectively and independently read MRI exams, first without contrast, then with contrast, using a 5-point cancer suspicion scale.

Main Results:

• 43 patients (42.2%) were diagnosed with CS PCa.
• No statistically significant difference was found in the detection of CS PCa between MRI exams with and without contrast.
• Accuracies, sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) were similar for both types of exams.

Conclusions:

• MRI exams with and without contrast-enhanced sequences demonstrated similar performance in detecting CS PCa.
• The addition of contrast sequences did not significantly improve the detection rate of clinically significant prostate cancer on MRI.