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New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer?

Publication ,  Journal Article
Holtz, JN; Silverman, RK; Tay, KJ; Browning, JT; Huang, J; Polascik, TJ; Gupta, RT
Published in: Abdom Radiol (NY)
March 2018

PURPOSE: Our objective is to determine the accuracy of multiparametric MRI (mpMRI) in predicting pathologic grade of prostate cancer (PCa) after radical prostatectomy (RP) using simple apparent diffusion coefficient metrics and, specifically, whether mpMRI can accurately separate disease into one of two risk categories (low vs. higher grade) or one of three risk categories (low, intermediate, or high grade) corresponding to the new prognostic grade group (PGG) criteria. METHODS: This retrospective, HIPAA-compliant, IRB-approved study included 140 patients with PCa who underwent 3 T mpMRI with endorectal coil and transrectal ultrasound-guided (TRUS-G) biopsy before RP. MpMRI was used to classify lesions using a two-tier (low-grade/PGG 1 vs. high-grade/PGG 2-5) or a three-tier system (low-grade/PGG 1 vs. intermediate-grade/PGG 2 vs. high-grade/PGG 3-5). Accuracy of mpMRI was compared against RP for each system. RESULTS: The predictive accuracy of mpMRI using the two-tier system is higher than when using three-tier system (0.77 and 0.45, respectively). There were similar rates of undergrading between mpMRI and TRUS-G biopsy compared to RP (16% & 21%; respectively); rate of overgrading was higher for mpMRI vs. TRUS-G biopsy compared to RP (42% & 17%, respectively). When mpMRI and TRUS-G biopsy are combined, rate of undergrading is 1.4% and overgrading is 11%. CONCLUSIONS: MpMRI predictive accuracy is higher when using a two-tier vs. a three-tier system, suggesting that advanced metrics may be necessary to delineate intermediate- from high-grade disease. Rates of under- and overgrading decreased when mpMRI and TRUS-G biopsy are combined, suggesting that these techniques may be complementary in predicting tumor grade.

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Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

March 2018

Volume

43

Issue

3

Start / End Page

702 / 712

Location

United States

Related Subject Headings

  • Ultrasonography, Interventional
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Predictive Value of Tests
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
 

Citation

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Holtz, J. N., Silverman, R. K., Tay, K. J., Browning, J. T., Huang, J., Polascik, T. J., & Gupta, R. T. (2018). New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer? Abdom Radiol (NY), 43(3), 702–712. https://doi.org/10.1007/s00261-017-1255-8
Holtz, Jamie N., Rachel Kloss Silverman, Kae Jack Tay, Jill T. Browning, Jiaoti Huang, Thomas J. Polascik, and Rajan T. Gupta. “New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer?Abdom Radiol (NY) 43, no. 3 (March 2018): 702–12. https://doi.org/10.1007/s00261-017-1255-8.
Holtz JN, Silverman RK, Tay KJ, Browning JT, Huang J, Polascik TJ, et al. New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer? Abdom Radiol (NY). 2018 Mar;43(3):702–12.
Holtz, Jamie N., et al. “New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer?Abdom Radiol (NY), vol. 43, no. 3, Mar. 2018, pp. 702–12. Pubmed, doi:10.1007/s00261-017-1255-8.
Holtz JN, Silverman RK, Tay KJ, Browning JT, Huang J, Polascik TJ, Gupta RT. New prostate cancer prognostic grade group (PGG): Can multiparametric MRI (mpMRI) accurately separate patients with low-, intermediate-, and high-grade cancer? Abdom Radiol (NY). 2018 Mar;43(3):702–712.
Journal cover image

Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

March 2018

Volume

43

Issue

3

Start / End Page

702 / 712

Location

United States

Related Subject Headings

  • Ultrasonography, Interventional
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prognosis
  • Predictive Value of Tests
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging