Fast prostate MRI vs. conventional multiparametric prostate MRI: comparison and outcomes.

PURPOSE

To assess the overall concordance of a fast prostate MRI (fpMRI) protocol versus conventional multiparametric prostate MRI (mpMRI) protocol.

METHODS

This is an IRB approved retrospective review of 100 men between the ages of 50 and 80 who underwent mpMRI exams from January 2016 to May 2021. The mpMRI exams selected came from three categories: Group A (PI-RADS 1-2); Group B (PI-RADS 3); and Group C (PI-RADS 4-5). Two masked radiologists independently reviewed and assigned each fpMRI case the highest possible lesion PI-RADS score. The collected fpMRI scores were then compared to the mpMRI results, PSA values, and available targeted biopsy outcomes.

RESULTS

The concordance rates between the two fpMRI reviewers and mpMRI for the individually assessed groups (A, B, C) were 0.69 (95% CI,0.62 to 0.75). The PPV of groups B or C combined for GS ≥ 7 for mpMRI, R1 fpMRI, and R2 fpMRI was 62% (40/64; 95% CI,0.50 to 0.74), 67% (40/60; 95% CI,0.53 to 0.78), and 72% (39/54; 95% CI,0.58 to 0.84), respectively. The negative predictive value (NPV) of group B or C combined for GS ≥ 7 on mpMRI, R1 fpMRI, and R2 fpMRI was 100% (3/3; 95% CI,29 to 100%), 100% (7/7; 95% CI,59 to 100%), and 92% (12/13; 95% CI,64 to 100%), respectively.

CONCLUSIONS

The concordance rates, PPV and NPV between the mpMRI and fpMRI results for groups B and C were moderately high, moderately high, and very high, respectively. This pilot study suggests that a larger prospective study might be beneficial to help establish fpMRI as a screening tool for prostate cancer.