Diagnostic Performance of Prospectively Assigned Likert Scale Scores to Determine Extraprostatic Extension and Seminal Vesicle Invasion With Multiparametric MRI of the Prostate

Freifeld, Yuval; Leon, Alberto Diaz de; Xi, Yin; Pedrosa, Iván; Roehrborn, Claus G.; Lotan, Yair; Francis, Franto; Costa, Daniel N.

doi:10.2214/ajr.18.20320

Cited by 18 publications

(8 citation statements)

References 17 publications

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“…Recent studies suggest that the Likert scale is an independent risk factor for ECE and can better predict it (23). The AUC values for the Likert scale were found to be 0.86 (24), higher than our study's value of 0.80. We hypothesize that this difference could be due to the inclusion of patients who underwent mpMRI after biopsy, which could have caused tissue proliferation and inflammation leading to irregular or thickened capsule morphology, resulting in higher Likert scores.…”

Section: Discussioncontrasting

confidence: 98%

Prediction of extracapsular extension in prostate cancer using the Likert scale combined with clinical and pathological parameters

Wang,

Huang,

Huang

et al. 2023

Front. Oncol.

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This study aimed to investigate the independent clinical, pathological, and radiological factors associated with extracapsular extension in radical prostatectomy specimens and to improve the accuracy of predicting extracapsular extension of prostate cancer before surgery.MethodsFrom August 2018 to June 2023, the clinical and pathological data of 229 patients with confirmed prostate cancer underwent radical prostatectomy from The Second Hospital of Yinzhou. The patients’ multiparametric magnetic resonance imaging data were graded using the Likert scale. The chi-square or independent-sample T-test was used to analyze the related factors for an extracapsular extension. Multivariate analysis was used to identify independent factors associated with extracapsular extension in prostate cancer. Additionally, receiver operating characteristic curve analysis was used to calculate the area under the curve and assess the diagnostic performance of our model. The clinical decision curve was used to analyze the clinical net income of Likert scale, biopsy positive rate, biopsy GG, and combined mode.ResultsOf the 229 patients, 52 had an extracapsular extension, and 177 did not. Multivariate analysis showed that the Likert scale score, biopsy grade group and biopsy positive rate were independent risk factors for extracapsular extension in prostate cancer. The area under the curves for the Likert scale score, biopsy grade group, and biopsy positive rate were 0.802, 0.762, and 0.796, respectively. Furthermore, there was no significant difference in the diagnostic efficiency for extracapsular extension (P>0.05). However, when these three factors were combined, the diagnostic efficiency was significantly improved, and the area under the curve increased to 0.905 (P<0.05). In the analysis of the decision curve, The clinical net income of the combined model is obviously higher than that of Likert scale, biopsy positive rate, and biopsy GG.ConclusionThe Likert scale, biopsy grade group and biopsy positive rate are independent risk factors for extracapsular extension in prostate cancer, and their combination can significantly improve the diagnostic efficiency for an extracapsular extension.

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Section: Discussioncontrasting

confidence: 98%

Prediction of extracapsular extension in prostate cancer using the Likert scale combined with clinical and pathological parameters

Wang,

Huang,

Huang

et al. 2023

Front. Oncol.

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“…MRIstaging can provide both, either as a stand-alone test or in combination with PSA and/or other clinical variables [52]. A Likert-scale approach, based on grouping of PPVs from low to high, might also be useful to convey the preoperative MRI staging results in a standardized way [53,54].…”

Section: D)mentioning

confidence: 99%

T-staging of prostate cancer: Identification of useful signs to standardize detection of posterolateral extraprostatic extension on prostate MRI

et al. 2020

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“…Previous conventional assessment of the 5-point EPE Likert scale (1 = highly unlikely, 2 = unlikely, 3 = equivocal or indeterminate, 4 = likely, and 5 = highly likely) have been employed widely in clinical practice, in which radiologists assign a score for the likelihood of EPE during MRI interpretation. However, the Likert scale primarily depends on radiologists' personal patterns and experience and then lacks objective criteria, resulting in widely varied accuracy (28)(29)(30). A prior meta-analysis showed that the pooled sensitivity and specificity were 0.57 and 0.91 for detection of EPE with mpMRI (31); by contrast, the EPE grading system yielded higher sensitivity but lower specificity and with overall similar diagnostic performance.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Extraprostatic Extension Grading System for Detection of Extraprostatic Extension in Prostate Cancer: A Diagnostic Systematic Review and Meta-Analysis

Shang

et al. 2022

Front. Oncol.

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PurposeTo evaluate the diagnostic performance of the extraprostatic extension (EPE) grading system for detection of EPE in patients with prostate cancer (PCa).Materials and MethodsWe performed a literature search of Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar to identify eligible articles published before August 31, 2021, with no language restrictions applied. We included studies using the EPE grading system for the prediction of EPE, with histopathological results as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were calculated with the bivariate model. Quality assessment of included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsA total of 4 studies with 1,294 patients were included in the current systematic review. The pooled sensitivity and specificity were 0.82 (95% CI 0.76–0.87) and 0.63 (95% CI 0.51–0.73), with the area under the hierarchical summary receiver operating characteristic (HSROC) curve of 0.82 (95% CI 0.79–0.85). The pooled LR+, LR−, and DOR were 2.20 (95% CI 1.70–2.86), 0.28 (95% CI 0.22–0.36), and 7.77 (95% CI 5.27–11.44), respectively. Quality assessment for included studies was high, and Deeks’s funnel plot indicated that the possibility of publication bias was low (p = 0.64).ConclusionThe EPE grading system demonstrated high sensitivity and moderate specificity, with a good inter-reader agreement. However, this scoring system needs more studies to be validated in clinical practice.

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Diagnostic Performance of Prospectively Assigned Likert Scale Scores to Determine Extraprostatic Extension and Seminal Vesicle Invasion With Multiparametric MRI of the Prostate

Cited by 18 publications

References 17 publications

Prediction of extracapsular extension in prostate cancer using the Likert scale combined with clinical and pathological parameters

Prediction of extracapsular extension in prostate cancer using the Likert scale combined with clinical and pathological parameters

T-staging of prostate cancer: Identification of useful signs to standardize detection of posterolateral extraprostatic extension on prostate MRI

Diagnostic Performance of Extraprostatic Extension Grading System for Detection of Extraprostatic Extension in Prostate Cancer: A Diagnostic Systematic Review and Meta-Analysis

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