Erik Rud1, Dagmar Klotz2, Kristin Rennesund3, Eduard Baco3, Viktor Berge3, Diep Lien4, Aud Svindland5, Eskild Lundeby3, Rolf E Berg3, Lars M Eri3, Heidi B Eggesbø6. 1. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Aker, Norway. 2. Department of Pathology, Oslo University Hospital, Ullevål, Norway. 3. Department of Urology, Oslo University Hospital, Aker, Norway. 4. Unit of Biostatistics and Epidemiology, Oslo University Hospital, Ullevål, Norway. 5. Department of Pathology, Oslo University Hospital, The Norwegian Radiumhospital, Oslo, Norway. 6. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Abstract
OBJECTIVE: To examine the performance of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for detecting the index tumour in patients with prostate cancer and to examine the agreement between MRI and histology when assessing tumour volume (TV) and overall tumour burden. PATIENTS AND METHODS: The study included 199 consecutive patients with biopsy confirmed prostate cancer randomised to MRI before radical prostatectomy from December 2009 to July 2012. MRI-detected tumours (MRTs) were ranked from 1 to 3 according to decreasing volume and were compared with histologically detected tumours (HTs) ranked from 1 to 3, with HT 1 = index tumour. Whole-mount section histology was used as a reference standard. The TVs of true-positive MRTs (MRTVs 1-3) were compared with the TVs found by histology (HTVs 1-3). All tumours were registered on a 30-sector map and by classifying each sector as positive/negative, the rate of true-positive and -negative sectors was calculated. RESULTS: The detection rate for the HT 1 (index tumour) was 92%; HT 2, 45%; and HT 3, 37%. The MRTV 1-3 vs the HTV 1-3 were 2.8 mL vs 4.0 mL (index tumour, P < 0.001), 1.0 mL vs 0.9 mL (tumour 2, P = 0.413), and 0.6 mL vs 0.5 mL (tumour 3, P = 0.492). The rate of true-positive and -negative sectors was 50% and 88%, κ = 0.39. CONCLUSION: A combination of T2W and DW MRI detects the index tumour in 92% of cases, although MRI underestimates both TV and tumour burden compared with histology.
RCT Entities:
OBJECTIVE: To examine the performance of T2-weighted (T2W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) for detecting the index tumour in patients with prostate cancer and to examine the agreement between MRI and histology when assessing tumour volume (TV) and overall tumour burden. PATIENTS AND METHODS: The study included 199 consecutive patients with biopsy confirmed prostate cancer randomised to MRI before radical prostatectomy from December 2009 to July 2012. MRI-detected tumours (MRTs) were ranked from 1 to 3 according to decreasing volume and were compared with histologically detected tumours (HTs) ranked from 1 to 3, with HT 1 = index tumour. Whole-mount section histology was used as a reference standard. The TVs of true-positive MRTs (MRTVs 1-3) were compared with the TVs found by histology (HTVs 1-3). All tumours were registered on a 30-sector map and by classifying each sector as positive/negative, the rate of true-positive and -negative sectors was calculated. RESULTS: The detection rate for the HT 1 (index tumour) was 92%; HT 2, 45%; and HT 3, 37%. The MRTV 1-3 vs the HTV 1-3 were 2.8 mL vs 4.0 mL (index tumour, P < 0.001), 1.0 mL vs 0.9 mL (tumour 2, P = 0.413), and 0.6 mL vs 0.5 mL (tumour 3, P = 0.492). The rate of true-positive and -negative sectors was 50% and 88%, κ = 0.39. CONCLUSION: A combination of T2W and DW MRI detects the index tumour in 92% of cases, although MRI underestimates both TV and tumour burden compared with histology.
Authors: C Kesch; J P Radtke; F Distler; S Boxler; T Klein; C Hüttenbrink; K Hees; W Roth; M Roethke; H P Schlemmer; M Hohenfellner; B A Hadaschik Journal: Urologe A Date: 2016-08 Impact factor: 0.639
Authors: B J King; T K Mann-Gow; M Kida; M K Plante; S D Perrapato; P Zvara Journal: Prostate Cancer Prostatic Dis Date: 2015-05-26 Impact factor: 5.554
Authors: U B Liehr; D Baumunk; S Blaschke; F Fischbach; B Friebe; F König; A Lemke; P Mittelstädt; M Pech; M Porsch; J Ricke; D Schindele; S Siedentopf; J J Wendler; M Schostak Journal: Radiologe Date: 2017-08 Impact factor: 0.635
Authors: J P Radtke; S Boxler; T H Kuru; M B Wolf; C D Alt; I V Popeneciu; S Steinemann; C Huettenbrink; C Bergstraesser-Gasch; T Klein; C Kesch; M Roethke; N Becker; W Roth; H-P Schlemmer; M Hohenfellner; B A Hadaschik Journal: Prostate Cancer Prostatic Dis Date: 2015-06-16 Impact factor: 5.554