Comparison of the diagnostic efficacy of biparametric and multiparametric MRI for the diagnosis of clinically significant prostate cancer with prostate-specific antigen gray zone
DONG Zhe
ZHANG Yun
WANG Haiyi
LIU Baichuan
DING Xiaohui
HAO Yuwei
XU Honghao
YE Huiyi
Abstract：Objective To investigate the diagnostic efficacy of biparametric MRI(bpMRI)and multiparametric MRI(mpMRI),based on the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1),for clinically significant prostate cancer(csPCa)in patients with prostate-specific antigen(PSA)levels in the gray zone(PSA 4-10 ng/mL).Methods A total 270 patients from 2 medical institutions(220 from Center 1,and 50 from Center 2)who had PSA levels in the gray zone and underwent prostate biopsy and MRI were retrospectively included,and the clinical and MRI data were analyzed.Patients were categorized into two groups based on the Gleason score:csPCa(177 patients)and non-csPCa(93 patients).Lesions were scored using bpMRI(T2WI,DWI)and mpMRI[T2WI,DWI,and dynamic contrast-enhanced MRI(DCE-MRI)]according to PI-RADS v2.1.Comparisons were made using independent samples t-test,Mann-Whitney U test,and Chi-square test for general patient data[age,PSA,prostate volume(PV),PSA density(PSAD)],bpMRI scores,and mpMRI scores.Receiver operator characteristic(ROC)curves were drawn to calculate the area under the curve(AUC),sensitivity,specificity,and accuracy,using prostate biopsy pathology results as the reference.The diagnostic efficacy of the two scoring methods for csPCa was compared using the DeLong test.Sensitivity and specificity were compared using the McNemar test.The inter-reader agreement for bpMRI and mpMRI scores was analyzed using the Kappa test.Results Compared to the non-csPCa group,the csPCa group had smaller PV and higher PSAD(both P＜0.05).A higher proportion of csPCa patients scored 4-5 on both bpMRI and mpMRI(76.8%vs.85.3%),while a higher proportion of non-csPCa patients scored 1-3(78.5%vs.74.2%).There was no statistically significant difference in AUC values between bpMRI and mpMRI for diagnosing csPCa(P＞0.05).The sensitivity of bpMRI was lower than that of mpMRI(76.8%vs.85.3%,P＜0.05),while the specificity of bpMRI was higher than that of mpMRI(78.5%vs.74.2%,P＜0.05).Inter-reader agreement was good for both bpMRI and mpMRI scores(κ=0.68 and κ=0.67,respectively).Conclusion Based on PI-RADS v2.1,the diagnostic efficacy of bpMRI and mpMRI for csPCa in the PSA gray zone is similar.
Keywords：Prostate imaging reporting and data systemMagnetic resonance imagingClinically significant prostate cancer
Publication Date：2024-05-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 328-334 )