Detecting recurrent prostate Cancer using multiparametric MRI, influence of PSA and Gleason grade

Venkatesan, Aradhana M.; Mudairu-Dawodu, Eniola; Duran, Cihan; Stafford, R. Jason; Yan, Yuanqing; Wei, Wei; Kundra, Vikas

doi:10.1186/s40644-020-00373-4

Cited by 13 publications

(9 citation statements)

References 39 publications

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“…In addition, the PSA value was the risk factor found in all clinical risk factors. This result is similar to a recent report on radiomic machine learning ( 29 ). The performance of both the radiomic signature and PSA value was high and comparable in the testing group in our study.…”

Section: Discussionsupporting

confidence: 92%

“…The performance of both the radiomic signature and PSA value was high and comparable in the testing group in our study. In a previous study, Calvocoressi ( 29 ) found that the older the patient, the higher risk of histological malignancy of prostate nodules. The OR and 95% CI values of prostate tissue with a worse prognosis were 2.21 (1.30~3.76) and 1.58 (0.90–2.76), respectively, for men aged over 80 and under 70 years old.…”

Section: Discussionmentioning

confidence: 95%

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Application Value of Radiomic Nomogram in the Differential Diagnosis of Prostate Cancer and Hyperplasia

et al. 2022

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ObjectiveProstate cancer and hyperplasia require different treatment strategies and have completely different outcomes; thus, preoperative identification of prostate cancer and hyperplasia is very important. The purpose of this study was to evaluate the application value of magnetic resonance imaging (MRI)-derived radiomic nomogram based on T2-weighted images (T2WI) in differentiating prostate cancer and hyperplasia.Materials and MethodsOne hundred forty-six patients (66 cases of prostate cancer and 80 cases of prostate hyperplasia) who were confirmed by surgical pathology between September 2019 and September 2019 were selected. We manually delineated T2WI of all patients using ITK-SNAP software and radiomic analysis using Analysis Kit (AK) software. A total of 396 tumor texture features were extracted. Subsequently, the effective features were selected using the LASSO algorithm, and the radiomic feature model was constructed. Next, combined with independent clinical risk factors, a multivariate Logistic regression model was used to establish a radiomic nomogram. The receiver operator characteristic (ROC) curve was used to evaluate the prediction performance of the radiomic nomogram. Finally, the clinical application value of the nomogram was evaluated by decision curve analysis.ResultsThe PSA and the selected imaging features were significantly correlated with the differential diagnosis of prostate cancer and hyperplasia. The radiomic model had good discrimination efficiency for prostate cancer and hyperplasia. The training set (AUC = 0.85; 95% CI: 0.77–0.92) and testing set (AUC = 0.84; 95% CI: 0.72–0.96) were effective. The radiomic nomogram, combined with the radiomic characteristics of MRI and independent clinical risk factors, showed better differentiation efficiency in the training set (AUC = 0.91; 95% CI: 0.85–0.97) and testing set (AUC = 0.90; 95% CI: 0.81–0.99). The decision curve showed the clinical application value of the radiomic nomogram.ConclusionThe radiomic nomogram of T2-MRI combined with clinical risk factors can easily identify prostate cancer and hyperplasia. It also provides suggestions for further clinical events.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Application Value of Radiomic Nomogram in the Differential Diagnosis of Prostate Cancer and Hyperplasia

et al. 2022

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“…Comparing mpMRI and 11 C-choline PET/CT, Kitajima et al [18] reported 52.4% of local recurrences were correctly diagnosed by both modalities whereas 36.1% were correctly diagnosed by only mpMRI; they reported mpMRI sensitivity, specificity, and accuracy for diagnosing local recurrence were 88.5, 84.6, and 87.4%, respectively. Venkatesan et al found in a clinical setting that mpMRI is very likely to be negative if PSA is less than 0.5 ng/ml for low Gleason-grade tumors but not high-grade, whereas, for high-grade tumors, mpMRI is almost always positive if PSA is greater than 1.5 ng/ml, suggesting that between these values, mpMRI is more likely to be diagnostic; and, in the latter scenario, mpMRI is more likely to be of value for guiding biopsy [19].…”

Section: Local Recurrencementioning

confidence: 98%

Hybrid magnetic resonance and PET imaging for prostate cancer recurrence

Rednam

Kundra

2023

Current Opinion in Oncology

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Purpose of reviewRecurrence post definitive local therapy by prostatectomy or radiation therapy is often detected via rise in serum prostate-specific antigen (PSA) levels; however, PSA rise does not localize the disease. Distinguishing local versus distant recurrence guides whether to choose subsequent local versus systemic therapy. The purpose of this article is to review imaging for prostate cancer recurrence post local therapy. Recent findingsAmong imaging modalities, multiparametric MRI (mpMRI) is commonly used to assess for local recurrence. New radiopharmaceuticals target prostate cancer cells and enable whole-body imaging. These tend to be more sensitive for lymph node metastases than MRI or computed tomography (CT) and for bone lesions than bone scan at lower PSA levels but can be limited for local prostate cancer recurrence. Given greater soft tissue contrast, similar criteria for lymph nodes, and greater sensitivity for prostate bone metastases, MRI is advantageous to CT. MRI of the whole body and mpMRI are now feasible within a reasonable time frame and complementary to PET imaging, enabling whole-body and pelvis-focused PET-MRI, which should be advantageous in the setting of recurrent prostate cancer.

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“…After radical surgery, mpMRI can be used to analyze the operation situs in case of biochemical recurrence. However, the performance of the examination depends on Prostate Specific Antigen (PSA) levels and the Gleason grade of the initial neoplasia, as per the study of Venkatesan et al which reported 87.2% negative examinations in cases of PSA less than 0.5 ng/mL in lower grade tumor and 88.9% positive examinations in cases of PSA higher than 1.5 ng/mL in higher grade tumor [ 78 ]. From this observation, the diagnostic contribution of mpMRI is most relevant in intermediate combinations of PSA levels and Gleason grade tumors.…”

Section: Diffusion-weighted Prostate Imagingmentioning

confidence: 99%

Diffusion-Weighted MRI in the Genitourinary System

Perrot

Zoua

Glessgen

et al. 2022

JCM

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Diffusion weighted imaging (DWI) constitutes a major functional parameter performed in Magnetic Resonance Imaging (MRI). The DW sequence is performed by acquiring a set of native images described by their b-values, each b-value representing the strength of the diffusion MR gradients specific to that sequence. By fitting the data with models describing the motion of water in tissue, an apparent diffusion coefficient (ADC) map is built and allows the assessment of water mobility inside the tissue. The high cellularity of tumors restricts the water diffusion and decreases the value of ADC within tumors, which makes them appear hypointense on ADC maps. The role of this sequence now largely exceeds its first clinical apparitions in neuroimaging, whereby the method helped diagnose the early phases of cerebral ischemic stroke. The applications extend to whole-body imaging for both neoplastic and non-neoplastic diseases. This review emphasizes the integration of DWI in the genitourinary system imaging by outlining the sequence’s usage in female pelvis, prostate, bladder, penis, testis and kidney MRI. In gynecologic imaging, DWI is an essential sequence for the characterization of cervix tumors and endometrial carcinomas, as well as to differentiate between leiomyosarcoma and benign leiomyoma of the uterus. In ovarian epithelial neoplasms, DWI provides key information for the characterization of solid components in heterogeneous complex ovarian masses. In prostate imaging, DWI became an essential part of multi-parametric Magnetic Resonance Imaging (mpMRI) to detect prostate cancer. The Prostate Imaging–Reporting and Data System (PI-RADS) scoring the probability of significant prostate tumors has significantly contributed to this success. Its contribution has established mpMRI as a mandatory examination for the planning of prostate biopsies and radical prostatectomy. Following a similar approach, DWI was included in multiparametric protocols for the bladder and the testis. In renal imaging, DWI is not able to robustly differentiate between malignant and benign renal tumors but may be helpful to characterize tumor subtypes, including clear-cell and non-clear-cell renal carcinomas or low-fat angiomyolipomas. One of the most promising developments of renal DWI is the estimation of renal fibrosis in chronic kidney disease (CKD) patients. In conclusion, DWI constitutes a major advancement in genitourinary imaging with a central role in decision algorithms in the female pelvis and prostate cancer, now allowing promising applications in renal imaging or in the bladder and testicular mpMRI.

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Detecting recurrent prostate Cancer using multiparametric MRI, influence of PSA and Gleason grade

Cited by 13 publications

References 39 publications

Application Value of Radiomic Nomogram in the Differential Diagnosis of Prostate Cancer and Hyperplasia

Application Value of Radiomic Nomogram in the Differential Diagnosis of Prostate Cancer and Hyperplasia

Hybrid magnetic resonance and PET imaging for prostate cancer recurrence

Diffusion-Weighted MRI in the Genitourinary System

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