Multiparametric MRI for prostate cancer localization in correlation to whole‐mount histopathology

Isebaert, Sofie; Bergh, Laura Van den; Haustermans, Karin; Joniau, Steven; Lerut, Evelyne; Wever, Liesbeth De; Keyzer, Frederik De; Budiharto, Tom; Slagmolen, Pieter; Poppel, Hendrik Van; Oyen, Raymond

doi:10.1002/jmri.23938

Cited by 152 publications

(122 citation statements)

References 42 publications

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“…17), and it was slightly higher than the correlation between tumor volume on T2-weighted MRI and histopathologic tumor volume reported by Turkbey and colleagues (r ¼ 0.63; ref. 23).…”

Section: Discussionmentioning

confidence: 54%

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Prostate MRI: Evaluating Tumor Volume and Apparent Diffusion Coefficient as Surrogate Biomarkers for Predicting Tumor Gleason Score

Donati

Afaq

Vargas³

et al. 2014

Clinical Cancer Research

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Purpose: To investigate whether tumor volume derived from apparent diffusion coefficient (ADC) maps (Volume ADC ) and tumor mean ADC value (ADC mean ) are independent predictors of prostate tumor Gleason score (GS).Experimental Design: Tumor volume and GS were recorded from whole-mount histopathology for 131 men (median age, 60 years) who underwent endorectal diffusion-weighted MRI for local staging of prostate cancer before prostatectomy. Volume ADC and ADC mean were derived from ADC maps and correlated with histopathologic tumor volume and GS. Univariate and multivariate analyses were performed to evaluate prediction of tumor aggressiveness. Areas under receiver-operating characteristics curves (AUC) were calculated to evaluate the performance of Volume ADC and ADC mean in discriminating tumors of GS 6 and GS !7.Results: Histopathology identified 116 tumor foci >0.5 mL. Volume ADC correlated significantly with histopathologic tumor volume (r ¼ 0.683). The correlation increased with increasing GS (r ¼ 0.453 for GS 6 tumors; r ¼ 0.643 for GS 7 tumors; r ¼ 0.980 for GS !8 tumors). Both Volume ADC (r ¼ 0.286) and ADC mean (r ¼ À0.309) correlated with GS. At univariate analysis, both Volume ADC (P ¼ 0.0325) and ADC mean (P ¼ 0.0033) could differentiate GS ¼ 6 from GS !7 tumor foci. However, at multivariate analysis, only ADC mean (P ¼ 0.0156) was a significant predictor of tumor aggressiveness (i.e., GS 6 vs. GS !7). For differentiating GS 6 from GS !7 tumors, AUCs were 0.644 and 0.704 for Volume ADC and ADC mean , respectively, and 0.749 for both parameters combined.Conclusion: In patients with prostate cancer, ADC mean is an independent predictor of tumor aggressiveness, but Volume ADC is not. The latter parameter adds little to the ADC mean in predicting tumor GS. Clin Cancer Res; 20(14); 3705-11. Ó2014 AACR.

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“…17), and it was slightly higher than the correlation between tumor volume on T2-weighted MRI and histopathologic tumor volume reported by Turkbey and colleagues (r ¼ 0.63; ref. 23).…”

Section: Discussionmentioning

confidence: 54%

“…Tumor volume measured on DWI correlates well with the histopathologic tumor volume (17,18). However, the relationship between ADC and prostate tumor volume and the potential synergy of these two parameters in evaluating prostate cancer aggressiveness have not been explicitly explored.…”

Section: Introductionmentioning

confidence: 99%

Prostate MRI: Evaluating Tumor Volume and Apparent Diffusion Coefficient as Surrogate Biomarkers for Predicting Tumor Gleason Score

Donati

Afaq

Vargas³

et al. 2014

Clinical Cancer Research

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“…Additionally, dynamic contrast-enhanced (DCE) MRI was not performed as it was not standard-of-care in our institution at the time of this study, although there is some evidence that it can help improve sensitivity over DWI alone. 27,42,43 However, most lesions were in the TZ and the recently updated PI-RADS guidelines suggest DCE-MRI has no role to play in assessment of the TZ in the presence of adequate DWI and T2-weighted imaging. 44 There is differing nomenclature between the radiological sector-maps for reporting MRI-tumour location and the Ginsburg uropathology system used for obtaining and reporting biopsies; this may account for some analysis errors, as correlation of the MRI location to biopsy sectors becomes more challenging.…”

Section: Discussionmentioning

confidence: 99%

Investigating the ability of multiparametric MRI to exclude significant prostate cancer prior to transperineal biopsy

Serrao

Barrett

Wadhwa

et al. 2015

CUAJ

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Introduction: We characterized false negative prostate magnetic resonance imaging (MRI) reporting by using histology derived from MRI-transrectal ultrasound (TRUS)-guided transperineal (MTTP) fusion biopsies.Methods: In total, 148 consecutive patients were retrospectively reviewed. Men underwent multiparametric MRI (mpMRI), reported by a consultant/attending radiologist in line with European Society of Urogenital Radiology (ESUR) standards. MTTP biopsy of the lesions was performed according to the Ginsburg recommendations. Cases with an MRI-histology mismatch were identified and underwent a second read by an experienced radiologist. A third review was performed with direct histology comparison to determine a true miss from an MRI-occult cancer. Statistical analysis was performed with McNemar's test. Results: False negative lesions were identified in 29 MRI examinations (19.6%), with a total of 46 lesions. Most false negative lesions (21/46) were located in the anterior sectors of the prostate. The second read led to a significant decrease of false-negative lesions with 7/29 further studies identified as positive on a patientby-patient basis (24.1% of studies, p = 0.016) and 11/46 lesions (23.9%; p = 0.001). Of these, 30 lesions following the first read and 23 lesions after the second read were considered significant cancer according to the University College London criteria. However, on direct comparison with histology, most lesions were MRI occult. Conclusion: We demonstrate that MRI can fail to detect clinically relevant lesions. Improved results were achieved with a second read but despite this, a number of lesions remain MRI-occult. Further advances in imaging are required to reduce false negative results. IntroductionCurrent methods for risk stratification of prostate cancer, including serum prostate-specific antigen (PSA) and transrectal ultrasound (TRUS)-guided biopsies, are limited by sampling error and low sensitivity and specificity.1-3 TRUSbiopsy can lead to inaccurate grading of 32% to 42% of cancers, 4-6 and may fail to detect 30% to 50% of cancers, particularly tumours in the anterior portion of the prostate. 7-12The improvement in multiparametric magnetic resonance imaging (mpMRI) in detecting prostate cancer has led to its recommendation in high-risk patients following a negative TRUS biopsy.13 MRI can then be used to guide subsequent biopsy either cognitively, in-bore (direct MRI-targeting), or by using MRI-TRUS fusion techniques.14-17 The latter combines anatomical MRI localization with the real-time guidance of ultrasound. Repeat biopsy is often undertaken by the transperineal (TP) route as this offers potential advantages over a transrectal route, including better sampling of the anterior and apical regions of the prostate, reduced false negative results, and a sterile approach. 18 mpMRI has the potential to accurately exclude prostate cancer and reduce biopsy burden. 19,20 To achieve this, it must have a high negative predictive value (NPV) on a patient-by-patient basis and maintain ...

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“…DCE takes advantage of the unique characteristics associated with the abnormal tumor vasculature to assess aggressiveness of the disease. The usefulness of DCE in detecting, localizing, and staging prostate cancer is well documented in literature [58,[86][87][88][89][90]. Additionally, several studies have reported promising findings on the utility of DCE parameters in discriminating prostate cancer based on aggressiveness of the disease [91,92].…”

Section: Dynamic Contrast-enhanced Imagingmentioning

confidence: 99%

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

et al. 2015

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The use of multiparametric MRI scans for the evaluation of men with prostate cancer has increased dramatically and is likely to continue expanding as new developments come to practice. However, it has not yet gained the same level of acceptance of other imaging tests. Partly, this is because of the use of suboptimal protocols, lack of standardization, and inadequate patient preparation. In this manuscript, we describe several practical aspects of prostate MRI that may facilitate the implementation of new prostate imaging programs or the expansion of existing ones.

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Multiparametric MRI for prostate cancer localization in correlation to whole‐mount histopathology

Abstract: Combining T2w, DCE, and DW imaging significantly improves prostate cancer localization.

Cited by 152 publications

References 42 publications

Prostate MRI: Evaluating Tumor Volume and Apparent Diffusion Coefficient as Surrogate Biomarkers for Predicting Tumor Gleason Score

Prostate MRI: Evaluating Tumor Volume and Apparent Diffusion Coefficient as Surrogate Biomarkers for Predicting Tumor Gleason Score

Investigating the ability of multiparametric MRI to exclude significant prostate cancer prior to transperineal biopsy

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

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