Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: Results from a prospective study

Renard-Penna, Raphaële; Rouprêt, Morgan; Compérat, Eva; Ayed, Ahmad; Coudert, Mathieu; Mozer, Pierre; Xylinas, Évanguelos; Bitker, Marc‐Olivier; Greniér, Philippe

doi:10.1016/j.urolonc.2011.02.017

Cited by 37 publications

(21 citation statements)

References 28 publications

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“…Several studies have assessed the value of preoperative MRI in patients with known prostate cancer for evaluation of ECE [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Assessment of ECE on MRI has traditionally been based on T2-weighted imaging [7,8].…”

Section: Extracapsular Extension In Prostate Cancer: Added Value Of Dmentioning

confidence: 99%

“…Assessment of ECE on MRI has traditionally been based on T2-weighted imaging [7,8]. However, with the advent of technologic advances in MRI, functional MRI such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) have recently been tested for their value in predicting ECE [9][10][11][12][13][14][15][16]. In particular, there is increasing evidence that the apparent diffusion coefficient (ADC) obtained from DWI may be used as a potential biomarker in predicting ECE in patients with prostate cancer.…”

Section: Extracapsular Extension In Prostate Cancer: Added Value Of Dmentioning

confidence: 99%

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Extracapsular Extension in Prostate Cancer: Added Value of Diffusion-Weighted MRI in Patients With Equivocal Findings on T2-Weighted Imaging

Woo

Cho

Kim

et al. 2015

American Journal of Roentgenology

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OBJECTIVE. The objective of our study was to evaluate diffusion-weighted imaging (DWI) and T2-weighted imaging for predicting extracapsular extension (ECE) in patients with prostate cancer. MATERIALS AND METHODS. One hundred seventeen patients underwent preoperative 3-T MRI and radical prostatectomy. Two radiologists evaluated ECE with T2-weighted imaging based on the Prostate Imaging Reporting and Data System (PI-RADS). Then, the apparent diffusion coefficient (ADC) of the tumor calculated from two b values (0, 1000 s/mm(2)) was measured. Interreader agreement of T2-weighted imaging scores was assessed with weighted kappa statistics. We compared T2-weighted imaging scores and ADC values between patients with ECE and those without ECE using the unpaired Student t test and evaluated their association with ECE using logistic regression analyses and ROC curves incorporating prostate-specific antigen value, Gleason score, clinical stage, and greatest percentage involved core length. The ADC values were also tested for differences between patients with ECE and those without ECE in subgroups stratified by the T2-weighted imaging criteria shown to have a high specificity for ECE. RESULTS. Fifty (42.7%) patients had ECE. There was substantial agreement for T2-weighted imaging scores (κ = 0.613). T2-weighted imaging scores and ADCs were significantly different in patients with ECE and those without ECE (p < 0.001). Multivariate analysis showed that the greatest percentage involved core length, T2-weighted imaging score, and ADC (p < 0.05) were independently predictive of ECE. The AUCs for these variables (range, 0.733-0.770) were not significantly different except for the AUC for clinical stage (0.552). The use of a high specificity (92.5%) setting for ECE divided the patients into the following groups: patients with a T2-weighted imaging score of ≥ 4 (n = 20) and patients with a T2-weighted imaging score of < 4 (n = 97). In patients with a T2-weighted imaging score of ≥ 4, the ADC was not significantly different between patients with ECE and those without ECE (p = 0.555). However, among patients with a T2-weighted imaging score of ≤ 3, the ADC value was significantly lower in patients with ECE (mean ± SD, 0.794 ± 0.116) than in those without ECE (1.027 ± 0.339) (p < 0.001). CONCLUSION. T2-weighted imaging scores and ADCs were independently associated with ECE, and the ADC had incremental value in patients without a high suspicion of ECE on T2-weighted imaging.

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Section: Extracapsular Extension In Prostate Cancer: Added Value Of Dmentioning

confidence: 99%

Section: Extracapsular Extension In Prostate Cancer: Added Value Of Dmentioning

confidence: 99%

Extracapsular Extension in Prostate Cancer: Added Value of Diffusion-Weighted MRI in Patients With Equivocal Findings on T2-Weighted Imaging

Woo

Cho

Kim

et al. 2015

American Journal of Roentgenology

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“…There were 20/21 (95.2%) studies that consistently demonstrated upstaging by MRI, 33,36 and upstaging by MRI compared to routine clinical staging. 12,13,16,17,20,21,23,30,32,34,[37][38][39][40][41][42][43][44][45] Upstaging by MRI was correct by pathology in seven studies, with a range from 11-85%. 16 …”

Section: Key Evidencementioning

confidence: 96%

Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

Salerno

Finelli

Morash

et al. 2016

CUAJ

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Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/ specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation. Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11-85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases. Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations.

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“…Thompson et al [8] studied the clinical application of MRI in PCa and found a specificity greater than 95 % in detecting T3 disease. Renard-Penna et al [9] also found pelvic MRI to provide reliable information with a high accuracy in staging PCa, especially in detecting extracapsular extension. However, multiparametric MRI interpretation should be left to the interpretation of experienced radiologists specialized in PCa imaging.…”

Section: Definition Of High-risk Pcamentioning

confidence: 96%

The role for surgeryin high-risk prostate cancer

Lanchon

Shariat

Rouprêt

2015

Wien Med Wochenschr

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High-risk prostate cancer (PCa) refers to a very heterogeneous subgroup of disease. Recent series have shown very promising results of radical prostatectomy (RP)-alone or part as a multimodality approach-in patients with high-risk PCa, with satisfactory survival curves even though biochemical recurrence rate was high. Adjuvant treatment (radiotherapy (RT) alone or combined with androgen deprivation) was necessary in 20 to 54 % of patients, notably in cases with positive surgical margins. As for functional outcomes, urinary continence was preserved in about 92 % of cases and overall potency in 60 %. When comparing RP versus RT as primary treatment for high-risk PCa, a recent meta-analysis found surgery to be associated with an improved cancer-specific mortality compared with RT. In selected high-risk PCa young patients, surgery appears to be a valid option. Patients should however be informed of the possibility of adjuvant treatment, as part of a multimodal approach.

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Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: Results from a prospective study

Cited by 37 publications

References 28 publications

Extracapsular Extension in Prostate Cancer: Added Value of Diffusion-Weighted MRI in Patients With Equivocal Findings on T2-Weighted Imaging

Extracapsular Extension in Prostate Cancer: Added Value of Diffusion-Weighted MRI in Patients With Equivocal Findings on T2-Weighted Imaging

Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

The role for surgeryin high-risk prostate cancer

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