(UroToday.com) The 2025 South Central AUA annual meeting included a session on prostate cancer, featuring a presentation from Dr. Beatriz Hernandez discussing the effectiveness of biparametric MRI for prostate cancer detection in Latin America. The diagnosis of prostate cancer is focused on early detection, while minimizing overdiagnosis and overtreatment. Multiparametric MRI is the gold standard diagnostic tool, utilizing T1-weighted, T2-weighted, diffusion-weighted imaging (DWI), and dynamic contrast enhancement (DCE) to effectively identify lesions that may be concerning for prostate cancer. In contrast, biparametric MRI employs only T2W and DWI without contrast, providing a cost-effective alternative. Indeed, MRI faces challenges, such as high costs and extended imaging times. The rising incidence of prostate cancer in Latin American populations highlights the urgent need for effective diagnostic strategies, and this study aimed to evaluate more efficient diagnostic approaches.
This cross-sectional study assessed biparametric MRI for detecting prostate cancer in male patients undergoing multiparametric MRI at Zambrano Hellion Medical Center from March 2022 to February 2024. Patients were assessed by PI-RADS 2.1, and biopsies were done for lesions that were ≥ PI-RADS 3. Patients with biopsies on lesions < PI-RADS 3 or prior treatment were excluded. Two radiologists analyzed T2-weighted and DWI sequences for lesions, reviewing complete multiparametric MRI for consensus.
A total of 42 patients met the inclusion criteria, with a mean age of 64 years (SD = 8.9). Using the senior radiologist's assessment of multiparametric MRI as the standard reference, the biparametric MRI demonstrated exceptional diagnostic performance, showing sensitivity, specificity, negative predictive value, and positive predictive value of 100%. In contrast, the junior radiologist's evaluation of biparametric MRI alongside multiparametric MRI reported a sensitivity of 80%, specificity of 85.2%, positive predictive value of 75%, and negative predictive value of 88.5%, resulting in an overall accuracy of 83.3%. Interobserver concordance analysis indicated moderate agreement, with a Kappa coefficient of 0.596 (p < 0.001). When considering biopsy results as the standard reference, the senior radiologist achieved the highest diagnostic precision, with a sensitivity of 100%, specificity of 66.7%, negative predictive value of 100%, and positive predictive value of 86.7%, resulting in an accuracy of 89.5% for both biparametric MRI and multiparametric MRI:
Dr. Hernandez concluded her presentation discussing the effectiveness of biparametric MRI for prostate cancer detection in Latin America with the following take home points:
- Biparametric MRI demonstrated comparable sensitivity and specificity to multiparametric MRI, suggesting it as a viable, cost-effective alternative, especially in resource-limited settings
- Radiologist expertise and proper study acquisition are crucial for optimizing diagnostic outcomes
Presented by: Beatriz Hernandez, Baylor College of Medicine, Houston, TX
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 South Central American Urological Association (AUA) Annual Meeting, Orlando, FL, Wed, Sept 10 – Sat, Sept 13, 2025.