JRM

Journal of Radiology in Medicine is an international journal that published original research and articles in all areas of radiology. Its publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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Original Article
mp-MRI of prostate gland with PI-RADS v2.1 assessment: correlation with fusion biopsy results
Aims: The aim of our study is to evaluate the correlation of patients reported as 3, 4 and 5 according to ‘Prostate Imaging Reporting Data System’ (PI-RADS) on 1.5 and 3 tesla (T) multiparametric prostate magnetic resonance imaging (mp-MRI) with fusion biopsy results and to find out the effectiveness of mp-MRI in directing to fusion biopsy.
Methods: In our institution, between 2017-2020, 73 patients who underwent targeted fusion biopsy were included in the study retrospectively. The patients had biopsy from a total of 116 lesions reported as PI-RADS 3, 4 and 5 (with v2 and v2.1 criteria) on the mp-MRI examinations. In our department, 1.5T (Symphony, Siemens, Germany) MRI was used until June 2018 for the imaging of patients. After this date, 3T (Ingenia, Philips Medical Systems, Netherlands) MRI was used. MRI images were re-examined independently by two radiologists. Both radiologists used PI-RADS v2.1 criteria for lesion scoring, since all the images were evaluated retrospectively.
Results: When the diagnosis of significant and insignificant cancers were considered together; with MRI, observer 1's sensitivity 93.10%, specificity 58.62%, positive predictive value (PPV) 42.85% and negative predictive value (NPV) 96.22%, observer 2’s sensitivity 89.65%, specificity 68,96%, PPV 49% and NPV 95.25% was calculated. When only clinically significant cancers were considered; observer 1's sensitivity 87.5%, specificity 69.11%, PPV 66.66% and NPV 88.67%, observer 2’s sensitivity 83.33%, specificity 80.88%, PPV 75.47% and NPV 87.30% was calculated. In the kappa test which was performed to calculate interobserver agreement between the two observers; k = 0.801 was calculated and found to be substantial agreement (p?0.01).
Conclusion: The high rate of malignant lesions scored as PI-RADS 4 and 5 in prostate MRI reveals that these patients should be directed to biopsy. Focus-oriented biopsy using MRI guidance increases the PPV and prevents unnecessary systemic biopsies and complications.


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Volume 2, Issue 1, 2025
Page : 12-16
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