Evidence map›Paper›PMID 33890152›Full record

Trial reportEuropean radiology2021

Bi- or multiparametric MRI in a sequential screening program for prostate cancer with PSA followed by MRI? Results from the Göteborg prostate cancer screening 2 trial.

Jonas Wallström, Kjell Geterud, Kimia Kohestani, Stephan E Maier, Marianne Månsson, Carl-Gustaf Pihl, Andreas Socratous, Rebecka Arnsrud Godtman, Mikael Hellström, Jonas Hugosson

Open access · hybridAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 48 citations in OpenAlex.

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  14. [Prostate cancer screening-current overview].Radiologie (Heidelberg, Germany) · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Jonas WallströmDepartment of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna Stråket 11B, 413 45, Gothenburg, Sweden. Jonas.wallstrom@gu.se.ORCID http://orcid.org/0000-0002-4453-6718
Kjell GeterudDepartment of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Kimia KohestaniDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Stephan E MaierDepartment of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna Stråket 11B, 413 45, Gothenburg, Sweden.
Marianne MånssonDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Carl-Gustaf PihlDepartment of Pathology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Andreas SocratousDepartment of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Rebecka Arnsrud GodtmanDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Mikael HellströmDepartment of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Bruna Stråket 11B, 413 45, Gothenburg, Sweden.
Jonas HugossonDepartment of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sahlgrenska University Hospital · SEUniversity of Gothenburg · SE

Funding

Cancerfonden CAN2016/492; CAN2017/620Göteborgs Läkaresällskap 877851The Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement ALFGBG671851; ALFGBG72401; ALFGBG774531Vetenskapsrådet 2016/01973
6 · The paper itself

Abstract

objectivesThe PIRADS Steering Committee has called for "higher quality data before making evidence-based recommendations on MRI without contrast enhancement as an initial diagnostic work up," however, recognizing biparametric (bp) MRI as a reasonable option in a low-risk setting such as screening. With bpMRI, more men can undergo MRI at a lower cost and they can be spared the invasiveness of intravenous access. The aim of this study was to assess cancer detection in bpMRI vs mpMRI in sequential screening for prostate cancer (PCa).

methodsWithin the ongoing Göteborg PCa screening 2 trial, we assessed cancer detection in 551 consecutive participants undergoing prostate MRI. In the same session, readers first assessed bpMRI and then mpMRI. Four targeted biopsies were performed for lesions scored PIRADS 3-5 with bpMRI and/or mpMRI.

resultsCancer was detected in 84/551 cases (15.2%; 95% CI: 12.4-18.4) with mpMRI and in 83/551 cases (15.1%; 95% CI: 12.3-18.2%) with bpMRI. The relative risk (RR) for cancer detection with bpMRI compared to mpMRI was 0.99 (95% one-sided CI: > 94.8); bpMRI was non-inferior to mpMRI (10% non-inferiority margin). bpMRI resulted in fewer false positives, 45/128 (35.2%), compared to mpMRI, 52/136 (38.2%), RR = 0.92; 95% CI: 0.84-0.98. Of 8 lesions scored positive only with mpMRI, 7 were false positives. The PPV for MRI and targeted biopsy was 83/128 (64.8%) for bpMRI and 84/136 (61.8%) for mpMRI, RR = 1.05, 95% CI: 1.01-1.10.

conclusionsIn a PSA-screened population, bpMRI was non-inferior to mpMRI for cancer detection and resulted in fewer false positives. KEY POINTS: • In screening for prostate cancer with PSA followed by MRI, biparametric MRI allows radiologists to detect an almost similar number of prostate cancers and score fewer false positive lesions compared to multiparametric MRI. • In a screening program, high sensitivity should be weighed against cost and risks for healthy men; a large number of men can be saved the exposure of gadolinium contrast medium by adopting biparametric MRI and at the same time allowing for a higher turnover in the MRI room.

Indexed as

Multiparametric Magnetic Resonance ImagingProstatic NeoplasmsEarly Detection of CancerHumansImage-Guided BiopsyMagnetic Resonance ImagingMaleProstate-Specific AntigenProstate-Specific AntigenContrast mediaEarly detection of cancerMultiparametric magnetic resonance imagingProstatic neoplasms

Identifiers

PMID33890152
PMCPMC8523442
OpenAlexW3156132892

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.