Comparative study between 1.5 and 3 Tesla multiparametric MRI systems using the PIRADS version 2 classification in the diagnosis of prostate cancer.

INTRODUCTION: The 3-Tesla multiparametric MRI (mpMRI) system represents a diagnostic advance for prostate cancer. Our aim is to demonstrate that the results in 1.5-Tesla mpMRI are not inferior compared to the 3-Tesla for the correct diagnosis of prostate cancer. MATERIAL AND METHODS: Non-inferiority comparative cross-sectional study between fusion-guided prostate biopsy results. 344 patients with clinical suspicion of prostate cancer (elevated PSA and/or suspicious DRE) and mpMRI interpreted and verified by the same radiologists in all cases, 270 in 1.5-Tesla and 74 in 3-Tesla, with at least one lesion PIRADSv2≥ 3. Exclusion criteria were positive biopsy or previous prostate treatment. We consider malignancy as ISUP≥ 1 and significant tumor as ISUP≥ 2. We used Wilcoxon and t-student test (central tendency measures), diagnostic test (gold standard: ISUP of targeted biopsy), Chi2 test and Z-test (comparison of prevalences and 95%CI malignancy and significant tumor according to mpMRI). RESULTS: Median prostate volume 50cc(IQR:33.5) and PSA 6.11ng/ml(IQR:3.39). Mean age 67.4±8.1years. Number of suspi-cious lesions/patient: mpMRI 1.3 (1.5-Tesla) and 1.5 (3-Tesla). No differences were found between mpMRI (homogeneous and comparable samples). 57% (1.5-Tesla) vs 66% (3-Tesla) of targeted biopsies were malignant, and 34%vs38% were significant tumor, with no significant differences. Se, Sp, PPV and NPV for malignancy (1.5-Tesla vs 3-Tesla) were 96%vs90%, 38%vs44%, 67%vs76%, and 86%vs69%, with no significant differences. CONCLUSIONS: There are no significant differences between 1.5-Tesla vs 3-Tesla mpMRI regarding targeted biopsy results. Not to have 3-Tesla mpMRI may not be a limitation to use 1.5-Tesla as a diagnostic test for the better diagnosis of prostate cancer.

Comparative study between 1.5 and 3 Tesla multiparametric MRI systems using the PIRADS version 2 classification in the diagnosis of prostate cancer

Introduction: The 3-Tesla multiparametric MRI (mpMRI) system represents a diagnostic advance for prostate cancer. Our aim is to demonstrate that the results in 1.5-Tesla mpMRI are not inferior compared to the 3-Tesla for the correct diagnosis of prostate cancer. Material and methods: Non-inferiority comparative cross-sectional study between fusion-guided prostate biopsy results. 344 patients with clinical suspicion of prostate cancer (elevated PSA and/or suspicious DRE) and mpMRI interpreted and verified by the same radiologists in all cases, 270 in 1.5-Tesla and 74 in 3-Tesla, with at least one lesion PIRADSv2≥ 3. Exclusion criteria were positive biopsy or previous prostate treatment. We consider malignancy as ISUP≥ 1 and significant tumor as ISUP≥ 2. We used Wilcoxon and t-student test (central tendency measures), diagnostic test (gold standard: ISUP of targeted biopsy), Chi2 test and Z-test (comparison of prevalences and 95%CI malignancy and significant tumor according to mpMRI). Results: Median prostate volume 50cc(IQR:33.5) and PSA 6.11ng/ml(IQR:3.39). Mean age 67.4±8.1years. Number of suspi-cious lesions/patient: mpMRI 1.3 (1.5-Tesla) and 1.5 (3-Tesla). No differences were found between mpMRI (homogeneous and comparable samples). 57% (1.5-Tesla) vs 66% (3-Tesla) of targeted biopsies were malignant, and 34%vs38% were significant tumor, with no significant differences. Se, Sp, PPV and NPV for malignancy (1.5-Tesla vs 3-Tesla) were 96%vs90%, 38%vs44%, 67%vs76%, and 86%vs69%, with no significant differences. Conclusions: There are no significant differences between 1.5-Tesla vs 3-Tesla mpMRI regarding targeted biopsy results. Not to have 3-Tesla mpMRI may not be a limitation to use 1.5-Tesla as a diagnostic test for the better diagnosis of prostate cancer (AU)

Introducción: Los equipos de RM multiparamétrica(RMmp) 3-Tesla suponen un avance diagnóstico en cáncerde próstata. El objetivo es demostrar que los resultados enequipos de 1,5-Tesla no son inferiores a los equipos de 3-Tesla para el correcto diagnóstico de cáncer de próstata.Material y métodos: Estudio transversal comparativo de no inferioridad entre resultados de biopsia fusión.344 pacientes con sospecha de cáncer de próstata (PSA elevado y/o tacto rectal sospechoso) y RMmp interpretada ycomprobada por los mismos radiólogos en todos los casos,270 con 1,5-Tesla y 74 con 3-Tesla, con al menos una imagen PIRADSv2≥ 3. Criterios de exclusión: biopsia positiva o tratamiento prostático previo. Consideramos malignidad como ISUP≥ 1 y tumor significativo como ISUP≥ 2.Comparamos medidas de tendencia central (test Wilcoxony t-student), prevalencias e IC95% (Chi2 y prueba-Z) y testde prueba diagnóstica (gold estándar: ISUP de biopsia dirigida) según RMmp empleado.Resultados: Medianas de volumen prostático50cc(IQR:33,5) y PSA 6,11ng/ml(IQR:3,39). La mediade edad fue 67,4±8,1años. El número de lesiones sospechosas/paciente fue 1,3 (1,5-Tesla) y 1,5 (3-Tesla). No encontramos diferencias entre RMmp (muestras homogéneasy comparables). 57%(1,5-Tesla) vs 66%(3-Tesla) biopsiasdirigidas presentaron malignidad, y 34%vs38% tumorsignificativo, sin diferencias significativas. Se, Sp, VPP yVPN para malignidad (1,5-Tesla vs 3-Tesla) de 96%vs90%,38%vs44%, 67%vs76%, y 86%vs69%, sin diferenciassignificativas.Conclusiones: No encontramos diferencias significativas entre RMmp de 1,5-Tesla y 3-Tesla respecto a los resultados de biopsia. No disponer de RMmp de 3-Tesla...(AU)