OBJECTIVE: The purpose of this study was to evaluate the utility of multiparametric MRI in localization of the index lesion of prostate cancer. MATERIALS AND METHODS: Fifty-one patients who underwent 3-T MRI of the prostate with a pelvic phased-array coil that included T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences before prostatectomy were included. Six radiologists assessed all images to identify the lesion most suspicious of being the index lesion, which was localized to one of 18 regions. A uropathologist using the same 18-region scheme reviewed the prostatectomy slides to localize the index lesion. MRI performance was assessed by requiring either an exact match or an approximate match (discrepancy of up to one region) between the MRI and pathologic findings in terms of assigned region. RESULTS: The pathologist identified an index lesion in 49 of 51 patients. In exact-match analysis, the average sensitivity was 60.2% (range, 51.0-63.3%), and the average positive predictive value (PPV) was 65.3% (range, 61.2-69.4%). In approximate-match analysis, the average sensitivity was 75.9% (range, 65.3-69.6%), and the average PPV was 82.6% (range, 79.2-91.4%). The sensitivity was higher for index lesions with a Gleason score greater than 6 in exact-match (74.8% vs 15.3%, p<0.001) and approximate-match (88.7% vs 36.1%, p=<0.001) analyses and for index lesions measuring at least 1 cm in approximate-match analysis (80.3% vs 58.3%, p=0.016). In exact-match analysis, 30.0%, 44.9%, and 79.1% of abnormalities found with one, two, and three MRI parameters represented the index lesion (p<0.001). CONCLUSION: The sensitivity and PPV of multiparametric MRI for index lesion localization were moderate, although they improved in the setting of more aggressive pathologic features and a greater number of abnormal MRI parameters, respectively.
OBJECTIVE: The purpose of this study was to evaluate the utility of multiparametric MRI in localization of the index lesion of prostate cancer. MATERIALS AND METHODS: Fifty-one patients who underwent 3-T MRI of the prostate with a pelvic phased-array coil that included T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences before prostatectomy were included. Six radiologists assessed all images to identify the lesion most suspicious of being the index lesion, which was localized to one of 18 regions. A uropathologist using the same 18-region scheme reviewed the prostatectomy slides to localize the index lesion. MRI performance was assessed by requiring either an exact match or an approximate match (discrepancy of up to one region) between the MRI and pathologic findings in terms of assigned region. RESULTS: The pathologist identified an index lesion in 49 of 51 patients. In exact-match analysis, the average sensitivity was 60.2% (range, 51.0-63.3%), and the average positive predictive value (PPV) was 65.3% (range, 61.2-69.4%). In approximate-match analysis, the average sensitivity was 75.9% (range, 65.3-69.6%), and the average PPV was 82.6% (range, 79.2-91.4%). The sensitivity was higher for index lesions with a Gleason score greater than 6 in exact-match (74.8% vs 15.3%, p<0.001) and approximate-match (88.7% vs 36.1%, p=<0.001) analyses and for index lesions measuring at least 1 cm in approximate-match analysis (80.3% vs 58.3%, p=0.016). In exact-match analysis, 30.0%, 44.9%, and 79.1% of abnormalities found with one, two, and three MRI parameters represented the index lesion (p<0.001). CONCLUSION: The sensitivity and PPV of multiparametric MRI for index lesion localization were moderate, although they improved in the setting of more aggressive pathologic features and a greater number of abnormal MRI parameters, respectively.
Authors: Matthew D Greer; Nathan Lay; Joanna H Shih; Tristan Barrett; Leonardo Kayat Bittencourt; Samuel Borofsky; Ismail Kabakus; Yan Mee Law; Jamie Marko; Haytham Shebel; Francesca V Mertan; Maria J Merino; Bradford J Wood; Peter A Pinto; Ronald M Summers; Peter L Choyke; Baris Turkbey Journal: Eur Radiol Date: 2018-04-12 Impact factor: 5.315
Authors: Marc A Bjurlin; Xiaosong Meng; Julien Le Nobin; James S Wysock; Herbert Lepor; Andrew B Rosenkrantz; Samir S Taneja Journal: J Urol Date: 2014-04-21 Impact factor: 7.450
Authors: Arjun Sivaraman; Rafael Sanchez-Salas; Eric Barret; Petr Macek; Pierre Validire; Marc Galiano; Francois Rozet; Xavier Cathelineau Journal: World J Urol Date: 2014-12-12 Impact factor: 4.226
Authors: Nelly Tan; Daniel J Margolis; David Y Lu; Kevin G King; Jiaoti Huang; Robert E Reiter; Steven S Raman Journal: AJR Am J Roentgenol Date: 2015-07 Impact factor: 3.959
Authors: Kirema Garcia-Reyes; Niccolò M Passoni; Mark L Palmeri; Christopher R Kauffman; Kingshuk Roy Choudhury; Thomas J Polascik; Rajan T Gupta Journal: Abdom Imaging Date: 2015-01
Authors: J P Radtke; T H Kuru; D Bonekamp; M T Freitag; M B Wolf; C D Alt; G Hatiboglu; S Boxler; S Pahernik; W Roth; M C Roethke; H P Schlemmer; M Hohenfellner; B A Hadaschik Journal: Prostate Cancer Prostatic Dis Date: 2016-05-17 Impact factor: 5.554