Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

Jager, Gerrit J.; Ruijter, Emiel; Kaa, C.A. van de; Rosette, Jean J.M.C.H. de la; Oosterhof, G.O.N.; Thornbury, John R.; Barentsz, Jelle O.

doi:10.2214/ajr.166.4.8610561

Cited by 235 publications

(129 citation statements)

References 28 publications

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“…Third, ADC measurements do not require the injection of a contrast agent, such as that required for dynamic contrast-enhanced MR. This study was undertaken with the goal of combining the advantages of both imaging techniques (the excellent soft-tissue resolution of T2-weighted imaging and functional information provided by DW MR).We found poor correlation between tumor volumes measured at T2-weighted imaging alone and at pathologic examination-a finding consistent with those of prior studies (16,17,19). Kirkham et al (16) provided an overview of the results of prior studies, which showed that overestimation of tumor volume occurs slightly more often than underestimation.…”

supporting

confidence: 78%

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Mazaheri¹,

Hricak²,

Fine³

et al. 2009

Radiology

190

130

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Purpose:To retrospectively determine the accuracy of diffusionweighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard. Materials and Methods:The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm 3 at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated. Results:In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm 2 /sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm 3 were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm 2 / sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm 2 /sec) was significantly higher (P ϭ .006) than that of T2-weighted imaging alone. Conclusion:Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement. RSNA, 2009 Supplemental Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article.A ccurate noninvasive measurement of prostate cancer tumor volume could substantially improve the determination of tumor prognosis and assist in the selection of appropriate treatment. Studies (1-4) have shown that pathologic tumor volume correlates with pathologic stage, pathologic Gleason grade, margin status, and disease progression after radical prostatectomy. Tumors smaller than about 0.5 cm 3 and with no Gleason pattern 4 or 5 cancer are considered to be clinically insignificant and potentially appropriate for deferred therapy (5). McNeal et al (6) found that capsule penetration, seminal vesicle invasion, and positive surgical margins all correlated strongly with cancer volume. The latter study also showed that metastasis is highly likely when tumor volume is larger than 12 cm 3 , whereas ...

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supporting

confidence: 78%

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Mazaheri¹,

Hricak²,

Fine³

et al. 2009

Radiology

190

130

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“…These findings of our study suggest that MRI, with its highresolution, cannot be replaced, especially for T-staging, and thus continues to have a role in the diagnostic assessment of prostate cancer -either when used alone or when used in combination with another modality in fusion imaging. In recent years, prostate cancer MRI has developed from the use of endorectal coil techniques with accuracies, sensitivities, and positive predictive values (PPV) of 79.8%, 85.3%, and 92.6% for cancers larger than 1 cm and of 24.2%, 26.2%, and 75.9% for cancers less than 1 cm in diameter and an accuracy of 68% for the differentiation of T2 and T3 prostate cancer to the use of body coils and multiparametric pulse sequences [14,15]. Multiparametric imaging offers the advantage of providing valid additive information on cancer extent outside the prostate, as for instance shown in a prospective study of Lista et al [16].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Ga-68 HBED-CC PSMA PET/CT for Tumor Staging in the Initial Diagnostic Assessment of Prostate Cancer

Schreiter¹,

Gericke²

2016

J Nucl Med Radiat Ther

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“…18 enhanced MR imaging is related to discrimination of cancer from prostatitis in the peripheral zone and from highly vascularized BPH nodules in the transition zone. 22 Other shortcomings are a limited use of standardized approaches for calibration and analysis, the shortage of uniform commercially available tools for pharmacokinetic analysis, and the lack of consensus in acquisition protocols. In multiparametric MR imaging examination, the high sensitivity of dynamic contrastenhanced MR may be used for initial evaluation of potential tumor locations.…”

Section: Discussionmentioning

confidence: 99%

Role of multiparametric MRI in detection of prostatic lesions; of evaluation contrast enhanced MRI, diffusion weighted imaging and MR spectroscopy in malignant and benign prostatic lesions

Yadav

Bhargava

2016

Int J Res Med Sci

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INTRODUCTIONProstate cancer is the most common cancer detected in men in the United States. Approximately 230,000 American men were diagnosed with prostate cancer in 2005.1 Prostate cancer is the second leading cause of cancer death for men.Despite the efficiency of clinical staging, it remains imperfect for precise local cancer staging and intra ABSTRACT Background: Prostate cancer is the most commonly diagnosed cancer in males and one of the leading causes of cancer-related death in men. Pretreatment assessment of prostate cancer is divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. The purpose of the study is to determine the diagnostic accuracy of multiparametric MRI for prostatic cancer detection using T2 weighted MR imaging, diffusion weighted imaging (DWI) and contrast enhanced MRI. To determine the use of MR spectroscopy in prostatic lesions. Methods: It is a prospective single institutional study done on 29 patients with prostate lesions and elevated PSA level. Axial, coronal and sagittal images were obtained using T1WI, T2WI and STIR sequences. Advanced sequences like Diffusion weighted images, Spectroscopy and post gadolinium T1WI were taken after the basic MRI images. Results: Study was done in 29 patients, age was ranging between 51years to 90 years, mean age is 70.7 years. On multiparametric MRI findings 45% were detected malignant lesions and 55% patients detected benign lesions. On biopsy correlation 42% of these cases turned out to be malignant and 58% as benign lesions. Detection of malignancy by T2WI imaging alone given sensitivity of 80.1% and specificity of 85.4%.By DWI alone sensitivity was 85.7% and specificity was 89.4%,on MRS sensitivity is 90.6% and specificity was 91.1%. Combined (MRI+DWI+MRS) gave sensitivity of 92.3% and specificity of 94.4% for detection of malignant prostatic lesion. Positive predictive value is 90% and negative predictive value was 88%. Conclusions: The best characterization of prostatic cancer in individual patients will most likely result from a multiparametric exam. Recent advances include additional functional and physiologic MR imaging techniques (diffusion weighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer.

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Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

Cited by 235 publications

References 28 publications

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume

Usefulness of Ga-68 HBED-CC PSMA PET/CT for Tumor Staging in the Initial Diagnostic Assessment of Prostate Cancer

Role of multiparametric MRI in detection of prostatic lesions; of evaluation contrast enhanced MRI, diffusion weighted imaging and MR spectroscopy in malignant and benign prostatic lesions

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