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Combined Analysis of Biparametric MRI and Prostate-Specific Antigen Density: Role in the Prebiopsy Diagnosis of Gleason Score 7 or Greater Prostate Cancer

 Suji Lee  ;  Young Taik Oh  ;  Dae Chul Jung  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Sung Yoon Park 
 American Journal of Roentgenology, Vol.211(3) : W166-W172, 2018 
Journal Title
 American Journal of Roentgenology 
Issue Date
MRI ; biparametric ; clinically significant ; prostate cancer ; prostate-specific antigen
OBJECTIVE: The objective of our study was to investigate the diagnostic performance of prebiopsy biparametric MRI (bpMRI) and prostate-specific antigen density (PSAD) for Gleason score (GS) 7 or greater prostate cancer (PCa). MATERIALS AND METHODS: Sixty-eight consecutive patients who underwent prebiopsy bpMRI and biopsy were included. Pathologic results of systemic and targeted biopsies were the reference standard. Qualitative analyses comprised Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) and modified PI-RADSv2 (mPI-RADSv2). Quantitative analyses comprised mean apparent diffusion coefficient (ADC) of tumor, 10th percentile ADC of tumor, mean ADC ratio (ADCR) between benign tissues and PCa, and 10th percentile ADCR between benign tissues and PCa. The AUCs of the following combined models for GS 7 or greater PCa were investigated: model 1, PSAD and PI-RADSv2; model 2, PSAD and mPI-RADSv2; model 3, PSAD and mean ADC; model 4, PSAD and 10th percentile ADC; model 5, PSAD and mean ADCR; and model 6, PSAD and 10th percentile ADCR. RESULTS: The rate of GS 7 or greater PCa was 45.6% (31/68). AUCs of bpMRI parameters were 0.816 for PI-RADSv2, 0.838 for mPI-RADSv2, 0.820 for mean ADC, 0.823 for 10th percentile ADC, 0.780 for mean ADCR, and 0.763 for 10th percentile ADCR (p > 0.05 in all comparisons), whereas AUCs of prostate-specific antigen (PSA)-based parameters were 0.650 for PSA and 0.745 for PSAD (PSA vs PSAD, p = 0.017). AUCs of the combined models from 1 to 6 were 0.860, 0.880, 0.837, 0.844, 0.811, and 0.806, respectively, for biopsy GS 7 or greater PCa (p > 0.05 in all comparisons). CONCLUSION: Combined analysis of prebiopsy bpMRI and PSAD is useful for identifying GS 7 or greater PCa.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
오영택(Oh, Young Taik) ORCID logo https://orcid.org/0000-0002-4438-8890
이수지(Lee, Suji) ORCID logo https://orcid.org/0000-0002-8770-622X
정대철(Jung, Dae Chul) ORCID logo https://orcid.org/0000-0001-5769-5083
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
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