Introduction:

Magnetic resonance imaging (MRI) is a core component in prostate cancer diagnosis and treatment management decision-making. We sought to determine the impact PI-QUAL scoring has on the performance characteristics of a negative prostate MRI scan for prostate biopsy results.

Methods:

We analyzed our prospectively annotated prostate MRI cohort who underwent prostate MRI between 3/2023-10/2023 who had available MRI, PI-QUAL, and systematic prostate biopsy pathology data. We determined csPCa(GG2+) rates for patients at each individual PI-QUAL score and further assessed for the impact of each individual sequence T2-Weighted Images(T2WI), Diffusion Weighted Images(DWI), Dynamic Contrast-Enhanced images(DCE) quality on detection rates. The impact of PSA density (PSAD) as an additional available clinical variable was evaluated across PI-QUAL quality.

Results:

128 patients were included for analysis. There were 12 csPCAs detected, 30 GG1 lesions, and 86 negative biopsies. Most scans were high quality(PIQUAL 4-5: 92; PI-QUAL 3: 28; PI-QUAL 1-2: 8). There was no difference in GG2+ detection rates based on overall PI-QUAL score as well as individual phase quality(T2WI, DWI, DCE, Table-1a). A negative scan had a NPV of 90.6% for csPCA, which was improved with PSAD cutoffs of 0.1, 0.15, and 0.2 respectively(100%, 98.2%, and 93.2%, Table-1b).

Conclusion:

Overall, a negative MRI scan provided excellent diagnostic accuracy regardless of PI-QUAL score at our subspecialized center.

Funding: N/A