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Article

Abbreviated Versus Multiparametric Prostate MRI in Active Surveillance for Prostate-Cancer Patients: Comparison of Accuracy and Clinical Utility as a Decisional Tool

by
Fabio Zattoni
1,*,
Silvio Maresca
2,
Fabrizio Dal Moro
1,
Iliana Bednarova
3,
Gianmarco Randazzo
1,
Giovanni Basso
1,
Giuseppe Reitano
1,
Gianluca Giannarini
4,
Chiara Zuiani
2 and
Rossano Girometti
2
1
Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, 35122 Padova, Italy
2
Department of Medicine, Institute of Radiology, University of Udine, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
3
Department of Breast Radiology, Veneto Institute of Oncology, IRCCS, 35128 Padua, Italy
4
Urology Unit, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2023, 13(4), 578; https://doi.org/10.3390/diagnostics13040578
Submission received: 2 December 2022 / Revised: 30 January 2023 / Accepted: 2 February 2023 / Published: 4 February 2023
(This article belongs to the Section Medical Imaging and Theranostics)
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Abstract

(1) Purpose: To compare the diagnostic accuracy between full multiparametric contrast-enhanced prostate MRI (mpMRI) and abbreviated dual-sequence prostate MRI (dsMRI) in men with clinically significant prostate cancer (csPCa) who were candidates for active surveillance. (2) Materials and Methods: Fifty-four patients with a diagnosis of low-risk PCa in the previous 6 months had a mpMRI scan prior to a saturation biopsy and a subsequent MRI cognitive transperineal targeted biopsy (for PI-RADS ≥ 3 lesions). The dsMRI images were obtained from the mpMRI protocol. The images were selected by a study coordinator and assigned to two readers blinded to the biopsy results (R1 and R2). Inter-reader agreement for clinically significant cancer was evaluated with Cohen’s kappa. The dsMRI and mpMRI accuracy was calculated for each reader (R1 and R2). The clinical utility of the dsMRI and mpMRI was investigated with a decision-analysis model. (3) Results: The dsMRI sensitivity and specificity were 83.3%, 31.0%, 75.0%, and 23.8%, respectively, for R1 and R2. The mpMRI sensitivity and specificity were 91.7%, 31.0%, 83.3%, and 23.8%, respectively, for R1 and R2. The inter-reader agreement for the detection of csPCa was moderate (k = 0.53) and good (k = 0.63) for dsMRI and mpMRI, respectively. The AUC values for the dsMRI were 0.77 and 0.62 for the R1 and R2, respectively. The AUC values for the mpMRI were 0.79 and 0.66 for R1 and R2, respectively. No AUC differences were found between the two MRI protocols. At any risk threshold, the mpMRI showed a higher net benefit than the dsMRI for both R1 and R2. (4) Conclusions: The dsMRI and mpMRI showed similar diagnostic accuracy for csPCa in male candidates for active surveillance.
Keywords: prostate MRI; prostate cancer; active surveillance; multiparametric MRI; abbreviated MRI protocol prostate MRI; prostate cancer; active surveillance; multiparametric MRI; abbreviated MRI protocol

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MDPI and ACS Style

Zattoni, F.; Maresca, S.; Dal Moro, F.; Bednarova, I.; Randazzo, G.; Basso, G.; Reitano, G.; Giannarini, G.; Zuiani, C.; Girometti, R. Abbreviated Versus Multiparametric Prostate MRI in Active Surveillance for Prostate-Cancer Patients: Comparison of Accuracy and Clinical Utility as a Decisional Tool. Diagnostics 2023, 13, 578. https://doi.org/10.3390/diagnostics13040578

AMA Style

Zattoni F, Maresca S, Dal Moro F, Bednarova I, Randazzo G, Basso G, Reitano G, Giannarini G, Zuiani C, Girometti R. Abbreviated Versus Multiparametric Prostate MRI in Active Surveillance for Prostate-Cancer Patients: Comparison of Accuracy and Clinical Utility as a Decisional Tool. Diagnostics. 2023; 13(4):578. https://doi.org/10.3390/diagnostics13040578

Chicago/Turabian Style

Zattoni, Fabio, Silvio Maresca, Fabrizio Dal Moro, Iliana Bednarova, Gianmarco Randazzo, Giovanni Basso, Giuseppe Reitano, Gianluca Giannarini, Chiara Zuiani, and Rossano Girometti. 2023. "Abbreviated Versus Multiparametric Prostate MRI in Active Surveillance for Prostate-Cancer Patients: Comparison of Accuracy and Clinical Utility as a Decisional Tool" Diagnostics 13, no. 4: 578. https://doi.org/10.3390/diagnostics13040578

APA Style

Zattoni, F., Maresca, S., Dal Moro, F., Bednarova, I., Randazzo, G., Basso, G., Reitano, G., Giannarini, G., Zuiani, C., & Girometti, R. (2023). Abbreviated Versus Multiparametric Prostate MRI in Active Surveillance for Prostate-Cancer Patients: Comparison of Accuracy and Clinical Utility as a Decisional Tool. Diagnostics, 13(4), 578. https://doi.org/10.3390/diagnostics13040578

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