Kim JG, et al. - Authors probed the rates and characteristics of missed cancers at prebiopsy multiparametric MRI with cancer-negative findings according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2 in men with suspected prostate cancer (PCa). Approximately 12.6% of cases of PCa, including 0.1–6.0% of clinically significant cancers were missed by prebiopsy 3-T multiparametric MRI with cancer-negative findings, in a cohort of biopsy-naive men and those who had undergone repeated biopsy.

Methods

• Experts enrolled a total of 584 consecutive men (biopsy naive,n=392; repeated biopsy,n=192) with suspected PCa who underwent prebiopsy 3-T multipara-metric MRI, followed by subsequent biopsies.
• They confirmed the cancer-positive findings at systemic biopsies and cognitive MRI-targeted biopsies, whereas cancer-negative findings were confirmed at systemic biopsies performed during subsequent follow-up.
• They determined the missing and detection rates of all PCa and clinically significant cancer according to 5 biopsy-based definitions.
• Researchers assessed the likelihood of PCa at multiparametric MRI according to PI-RADS version 2, and compared the results.

Results

• Findings suggested that in 25% of patients, pathologically confirmed cancers were found.
• As per results, in 99 men (17%) cancer-positive MRI findings were seen and, of these, 85.9% had PCa.
• Data demonstrated that out of 485 men with cancer-negative MRI findings, a total of 61 (12.6%) had PCa, including 46 men in the biopsy-naive group and 15 men in the repeated-biopsy group.
• The rate of missed cancers at MRI was 0.1-6.0% for clinically significant cancers, and the detection rate was 21.2-83.5%.
• Experts noted that for detecting PCa, 96.8% specificity, 87.2% accuracy, and 87.4% negative predictive value was seen with multiparametric MRI.