Multiparametric Magnetic Resonance Imaging and Image-Guided Biopsy to Detect Seminal Vesicle Invasion by Prostate Cancer

Raskolnikov, Dima; George, Arvin; Rais‐Bahrami, Soroush; Türkbey, Barış; Shakir, Nabeel; Okoro, Chinonyerem; Rothwax, Jason; Walton-Diaz, Annerleim; Siddiqui, M. Minhaj; Su, Daniel; Stamatakis, Lambros; Merino, María J.; Wood, Bradford J.; Choyke, Peter L.; Pinto, Peter A.

doi:10.1089/end.2014.0250

Cited by 44 publications

(22 citation statements)

References 27 publications

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“…Furthermore, it can detect SVI and ECE as well as pelvic LNI at satisfactory levels in the follow-up of patients who are deemed as clinically insignificant. Its sensitivity is reported as >80% and specificity is reported as >90% in the latest series (27)(28)(29)(30). However, the results of mp-MRI are not yet included within the scope of active surveillance criteria or decision algorithm.…”

Section: Discussionmentioning

confidence: 99%

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

Özden¹,

Aktaş²,

Baykam³

et al. 2015

JAREM

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Objective: The Epstein criteria are used for the prediction of clinically insignificant prostate cancer and the determination of the patients who are suitable for avoiding or delaying active treatments that have many potential serious side-effects. In the present study, we aimed to retrospectively evaluate and interpret the oncologic outcomes of the patients who underwent radical retropubic prostatectomy (RRP) but were potentially eligible for active surveillance based on the Epstein criteria. Methods:Records of 305 patients who underwent RRP in our clinic between the years 2000 and 2014 for clinically localized prostate cancer were analyzed. Of these patients, 18 who met all the conditions of the Epstein criteria [clinical T1c, biopsy Gleason score (GS) <7, the number of cancer positive biopsy cores <3, cancer involvement in any core <50%, and prostate specific antigen (PSA) density <0.15 ng/mL 2 ] were included. The patients with an increased surgical specimen GS compared with that of biopsy or those with non-organ-confined disease were considered to have clinically significant disease.Results: The mean age, serum PSA level, and prostate volume of all the 305 patients were 62.8±6.1 years, 10.8±6.9 ng/mL, and 46.2±22.1 mL, respectively. Eighty-six patients (28.2%) were with extracapsular extension (ECE), 58 (19.0%) with positive surgical margin (PSM), 39 (12.8%) with seminal vesicle invasion (SVI), and 16 (5.2%) with lymph node involvement (LNI). Biochemical recurrence was detected in 55 of the 305 patients (20.9%) during the mean follow-up period of 71.2±37.3 months after RRP. Of the 305 patients who underwent RRP, 18 (5%) met the Epstein criteria. The mean age, serum PSA level, and prostate volume of these patients were 61.6±6.01 years, 5.51±1.1 ng/mL, and 45.2±10.13 mL, respectively. Five patients (27.8%) were with extracapsular extension (ECE), 4 (22.5%) with an increased GS, and 1 (5.5%) with both ECE and increased GS. A total of eight patients (44.4%) were detected to have clinically significant disease. None of the patients was with SVI or LNI. Biochemical recurrence was not detected in any of the patients during the mean follow-up period of 48.7±31.2 months after RRP. Conclusion:Our results showed that the Epstein criteria may misguide us for the prediction of clinically insignificant prostate cancers. A notable proportion of our patients potentially eligible for active surveillance based on the Epstein criteria were postoperatively revealed to have clinically significant disease. If those patients had not undergone surgery, they may have lost their chance to undergo active treatment for their cancer. (JAREM 2015; 5: 6-9)

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Section: Discussionmentioning

confidence: 99%

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

Özden¹,

Aktaş²,

Baykam³

et al. 2015

JAREM

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“…However, this study does provide evidence for some usefulness of functional MRI sequences when compared with conventional MRI alone. Indeed, a recent study found that mpMRI suspicion score was statistically significant for predicting SVI (p = 0.04) and that lesions moderately or highly suspicious for SVI on mpMRI were confirmed on histopathology 71% of the time [96].…”

Section: • Ecementioning

confidence: 99%

Risk stratification of prostate cancer: integrating multiparametric MRI, nomograms and biomarkers

et al. 2016

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Accurate risk stratification of prostate cancer is achieved with a number of existing tools to ensure the identification of at-risk patients, characterization of disease aggressiveness, prediction of cancer burden and extrapolation of treatment outcomes for appropriate management of the disease. Statistical tables and nomograms using classic clinicopathological variables have long been the standard of care. However, the introduction of multiparametric MRI, along with fusion-guided targeted prostate biopsy and novel biomarkers, are being assimilated into clinical practice. The majority of studies to date present the outcomes of each in isolation. The current review offers a critical and objective assessment regarding the integration of multiparametric MRI and fusion-guided prostate biopsy with novel biomarkers and predictive nomograms in contemporary clinical practice.

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“…In a cohort of 376 patients, the sensitivity and the specificity for SVI were 49% and 98%, respectively (14). In a study of 822 patients, 31 had suspected SVI on mpMRI; in this population, the rate of detection with MRI-targeted biopsy was 65% (15). Therefore, mpMRI has limitations in sensitivity but yields few false-positive findings and therefore has high specificity.…”

Section: Mri and Prostate Cancermentioning

confidence: 99%

Evaluation of Prostate Cancer with PET/MRI

et al. 2016

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In the ongoing effort to understand and cure prostate cancer, imaging modalities are constantly evolving to assist in clinical decisions. Multiparametric MRI can be used to direct prostate biopsies, improve diagnostic yield, and help clinicians make more accurate decisions. PET is superior in providing biologic information about the cancer and is sensitive and highly specific. Integrated PET/MRI is a welcome technical advance with great potential to influence the diagnosis and management of prostate cancer in clinical practice.

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Multiparametric Magnetic Resonance Imaging and Image-Guided Biopsy to Detect Seminal Vesicle Invasion by Prostate Cancer

Cited by 44 publications

References 27 publications

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

Risk stratification of prostate cancer: integrating multiparametric MRI, nomograms and biomarkers

Evaluation of Prostate Cancer with PET/MRI

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