The Predictive Value of Endorectal 3 Tesla Multiparametric Magnetic Resonance Imaging for Extraprostatic Extension in Patients with Low, Intermediate and High Risk Prostate Cancer

Somford, Diederik M.; Hamoen, E.H.J.; Fütterer, Jurgen J.; Basten, J.P. van; Kaa, Christina A. Hulsbergen‐van de; Vreuls, Willem; Oort, Inge M. van; Vergunst, H.; Kiemeney, L.A.L.M.; Barentsz, Jelle O.; Witjes, J. Alfred

doi:10.1016/j.juro.2013.05.021

Cited by 165 publications

(112 citation statements)

References 29 publications

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“…[4,5,[9][10][11] In our study, the specificity, sensitivity, and positive and negative predictive values of ECE were 95%, 25%, 66%, and 77%, respectively. We evaluated the patients who had RARP with or without preoperative MRIguided dissection planning.…”

Section: Discussionsupporting

confidence: 47%

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The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

Tavukçu

Aytaç

Balci

et al. 2017

Turkish Journal of Urology

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Objective: We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy. Material and methods:We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity.Results: There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high-risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%). Conclusion:Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.Keywords: Dissection; magnetic resonance; prostate; prostatectomy.Cite this article as: Tavukçu HH, Aytaç Ö, Balcı NC, Kulaksızoğlu H, Atuğ F. The efficacy and utilisation of preoperative multiparametric magnetic resonance ımaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan? Turk J Urol 2017; 43(4): 470-5.

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Section: Discussionsupporting

confidence: 47%

“…[5][6][7][8][9] It is estimated that mp-MRI detects ECE with 48-76% accuracy. [4,[10][11][12][13][14] Walz et al [15] detailed the anatomy of the prostate and adjacent tissues, especially the fascia and NVB. In light of these studies, preoperative mp-MRI of the prostate may guide surgeons' dissection plans for RARP.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

Tavukçu

Aytaç

Balci

et al. 2017

Turkish Journal of Urology

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“…There were 20/21 (95.2%) studies that consistently demonstrated upstaging by MRI, 33,36 and upstaging by MRI compared to routine clinical staging. 12,13,16,17,20,21,23,30,32,34,[37][38][39][40][41][42][43][44][45] Upstaging by MRI was correct by pathology in seven studies, with a range from 11-85%. 16 …”

Section: Key Evidencementioning

confidence: 97%

“…There were 19/49 (38.8%) primary studies of MRI ≥1.5 T + ER ± DWI, DCE, MRS that considered the detection of EPE and/or SVI [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] (Figs. 2, 3).…”

Section: Key Evidencementioning

confidence: 99%

Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

Salerno

Finelli

Morash

et al. 2016

CUAJ

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Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/ specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation. Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11-85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases. Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations.

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“…SVI is also relatively common, with recent large surgical series reporting rates of 4.5% to 12.7%. [4][5][6] For all of these reasons, early knowledge of SVI is critical for appropriate patient counseling, treatment selection, and planning.…”

Section: Introductionmentioning

confidence: 99%

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

Raskolnikov

George

Rais‐Bahrami

et al. 2014

Journal of Endourology

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Objectives: To evaluate the correlation between multiparametric prostate MRI (MP-MRI) suspicion for seminal vesicle invasion (SVI) by prostate cancer (PCa) and pathology on MRI/ultrasound (US) fusion-guided biopsy. Patients and Methods: From March 2007 to June 2013, 822 patients underwent MP-MRI at 3 Tesla and MRI/ US fusion-guided biopsy. Of these, 25 patients underwent targeted biopsy of the seminal vesicles (SVs). In six patients, bilateral SVI was suspected, resulting in 31 samples. MP-MRI findings that triggered these SV biopsies were scored as low, moderate, or high suspicion for SVI based on the degree of involvement on MRI. Correlative prostate biopsy and radical prostatectomy (RP) pathology were reviewed by a single genitourinary pathologist. Results: At the time of MP-MRI, the median age was 64 years with a median prostate-specific antigen of 10.74 ng/mL. Of the 31 SV lesions identified, MP-MRI suspicion scores of low, moderate, and high were assigned to 3, 19, and 9 lesions, respectively. MRI/US fusion-guided biopsy detected SVI in 20/31 (65%) of cases. For the four patients who underwent RP after a preoperative assessment of SVI, biopsy pathology and RP pathology were concordant in all cases. Conclusions: As this technology becomes more available, MP-MRI and MRI/US fusion-guided biopsy may play a role in the preoperative staging for PCa. Future work will determine if improved preoperative staging leads to better surgical outcomes.

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The Predictive Value of Endorectal 3 Tesla Multiparametric Magnetic Resonance Imaging for Extraprostatic Extension in Patients with Low, Intermediate and High Risk Prostate Cancer

Cited by 165 publications

References 29 publications

The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?

Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

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

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