Clinical and Imaging Predictors of False-Positive and False-Negative Results in Prostate Multiparametric MRI Using...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate multiparametric MRI (mpMRI) is crucial for prostate cancer detection.
• The Prostate Imaging and Reporting Data System version 2 (PI-RADS v2) is widely used for standardized interpretation.
• False-positive (FP) and false-negative (FN) results can impact clinical decision-making.

Purpose of the Study:

• To identify predictors of false-positive (FP) and false-negative (FN) results in prostate cancer detection using prostate mpMRI with PI-RADS v2.
• To evaluate the independent predictive value of prostate-specific antigen (PSA) density and patient age.

Main Methods:

• Retrospective cohort study of 2548 patients undergoing prostate mpMRI with PI-RADS v2.
• Analysis of prospective PI-RADS v2 scores, subsequent biopsy results, patient age, lesion characteristics, and PSA density.
• Logistic regression was used to assess predictors of FP and FN results.

Main Results:

• FP results were associated with younger age, smaller lesions, transition zone location, and low PSA density.
• FN results were associated with older age and high PSA density.
• PSA density and patient age independently predicted both FP and FN results.

Conclusions:

• Prostate-specific antigen (PSA) density and patient age are significant independent predictors of false-positive and false-negative prostate cancer detection at mpMRI using PI-RADS v2.
• Incorporating these factors into mpMRI interpretation may enhance diagnostic accuracy and improve prostate cancer diagnosis.
• These predictors are not currently part of the PI-RADS v2 scoring system.