Negative predictive value of prostate multi-parametric magnetic resonance imaging among men with negative prostate biopsy and elevated PSA – a clinical outcome retrospective cohort study

AbstractPurpose:To estimate the negative predictive value (NPV) of prostate mpMRI in the detection of clinically significant (Gleason ≥7) prostate cancer (csPCa) at long-term follow-up (median 6.7 years, range 2.6-10.7 years), in men with negative pre-MRI biopsy and to assess the diagnostic performance of mpMRI in detecting csPCa over this time.Materials and Methods:Following Institutional REB-approval, men with prostate mpMRI following a biopsy between 2004-2009 were identified retrospectively from a cancer registry database and MRI reports. The mpMRI sequences comprised T2-weighted and dynamic contrast-enhanced series (2004–2005) with diffusion-weighted imaging 2006 onwards. Clinical outcomes were assessed up to July 2015 by review of subsequent pathology results, PSA levels and review of electronic patient records. The primary outcome was csPCa diagnosis by follow-up. We also estimated the sensitivity, specificity, PPV and NPV of all prostate mpMRI during the period.Results:502 mpMRI with a prior biops...