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What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?

(2016) EUROPEAN RADIOLOGY. 26(4). p.1098-1107
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Abstract
Objective: To analyse the characteristics of prostate cancers (PrCa) detected following negative multiparametric magnetic resonance imaging (mpMRI). Materials and methods: Eight hundred and thirty patients with elevated prostate-specific antigen (mean 11.9 mu g/l) underwent mpMRI of the prostate at 1.5 Tesla with endorectal coil. The characteristics of all PrCa detected within 2 years after a negative mpMRI were analysed. Primary Gleason grade 4 or any grade 5 PrCa were considered high-grade (HG), Gleason score 3 + 4 intermediate grade (IG) and Gleason score a parts per thousand currency sign3 + 3 low-grade (LG). Tumour size was considered 'small' when < 1 cm on radical prostatectomy specimen or limited to a parts per thousand currency sign2 cores on prostate biopsy. Results: mpMRI was negative in 391 patients (47.1 %). In 124 patients (31.7 %) PrCa was detected within 2 years. Eighty-four (67.7 %) were LG, 22 (17.7 %) IG and 18 (14.5 %) HG. 119 (96.0 %) of the missed PrCa were organ-confined. The negative predictive value was 95.4 % (373/391) for HG PrCa. Among the 18 missed HG PrCa, 15 (83.3 %) were organ-confined and 12 (66.6 %) were small. Conclusion: The majority of missed tumours on mpMRI were low grade and organ-confined. In patients with elevated PSA and a negative mpMRI, consideration could be given to continued surveillance rather than immediate biopsy.
Keywords
Prostatic neoplasms, Prostate, Magnetic resonance imaging, Magnetic resonance spectroscopy, Diffusion magnetic resonance imaging, CLINICAL-SIGNIFICANCE, TUMOR VOLUME, FOLLOW-UP, MRI, BIOPSY, MEN, DIAGNOSIS, CARCINOMA, ACCURACY, ABSENCE

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Chicago
De Visschere, Pieter, Leslie Naesens, Louis Libbrecht, Charles Van Praet, Nicolaas Lumen, Valérie Fonteyne, EVA PATTYN, and Geert Villeirs. 2016. “What Kind of Prostate Cancers Do We Miss on Multiparametric Magnetic Resonance Imaging?” European Radiology 26 (4): 1098–1107.
APA
De Visschere, Pieter, Naesens, L., Libbrecht, L., Van Praet, C., Lumen, N., Fonteyne, V., PATTYN, E., et al. (2016). What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging? EUROPEAN RADIOLOGY, 26(4), 1098–1107.
Vancouver
1.
De Visschere P, Naesens L, Libbrecht L, Van Praet C, Lumen N, Fonteyne V, et al. What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging? EUROPEAN RADIOLOGY. 2016;26(4):1098–107.
MLA
De Visschere, Pieter, Leslie Naesens, Louis Libbrecht, et al. “What Kind of Prostate Cancers Do We Miss on Multiparametric Magnetic Resonance Imaging?” EUROPEAN RADIOLOGY 26.4 (2016): 1098–1107. Print.
@article{6884501,
  abstract     = {Objective: To analyse the characteristics of prostate cancers (PrCa) detected following negative multiparametric magnetic resonance imaging (mpMRI). 
Materials and methods: Eight hundred and thirty patients with elevated prostate-specific antigen (mean 11.9 mu g/l) underwent mpMRI of the prostate at 1.5 Tesla with endorectal coil. The characteristics of all PrCa detected within 2 years after a negative mpMRI were analysed. Primary Gleason grade 4 or any grade 5 PrCa were considered high-grade (HG), Gleason score 3 + 4 intermediate grade (IG) and Gleason score a parts per thousand currency sign3 + 3 low-grade (LG). Tumour size was considered 'small' when {\textlangle} 1 cm on radical prostatectomy specimen or limited to a parts per thousand currency sign2 cores on prostate biopsy. 
Results: mpMRI was negative in 391 patients (47.1 \%). In 124 patients (31.7 \%) PrCa was detected within 2 years. Eighty-four (67.7 \%) were LG, 22 (17.7 \%) IG and 18 (14.5 \%) HG. 119 (96.0 \%) of the missed PrCa were organ-confined. The negative predictive value was 95.4 \% (373/391) for HG PrCa. Among the 18 missed HG PrCa, 15 (83.3 \%) were organ-confined and 12 (66.6 \%) were small. 
Conclusion: The majority of missed tumours on mpMRI were low grade and organ-confined. In patients with elevated PSA and a negative mpMRI, consideration could be given to continued surveillance rather than immediate biopsy.},
  author       = {De Visschere, Pieter and Naesens, Leslie and Libbrecht, Louis and Van Praet, Charles and Lumen, Nicolaas and FONTEYNE, VALERIE and PATTYN, EVA and Villeirs, Geert},
  issn         = {0938-7994},
  journal      = {EUROPEAN RADIOLOGY},
  keyword      = {Prostatic neoplasms,Prostate,Magnetic resonance imaging,Magnetic resonance spectroscopy,Diffusion magnetic resonance imaging,CLINICAL-SIGNIFICANCE,TUMOR VOLUME,FOLLOW-UP,MRI,BIOPSY,MEN,DIAGNOSIS,CARCINOMA,ACCURACY,ABSENCE},
  language     = {eng},
  number       = {4},
  pages        = {1098--1107},
  title        = {What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?},
  url          = {http://dx.doi.org/10.1007/s00330-015-3894-x},
  volume       = {26},
  year         = {2016},
}

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