Nelly Tan1, Daniel J Margolis1, David Y Lu2, Kevin G King1, Jiaoti Huang2, Robert E Reiter3, Steven S Raman1,3. 1. 1 Department of Radiology, David Geffen School of Medicine at UCLA, Box 957437, RRUMC 1621, Los Angeles, CA 90095. 2. 2 Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, CA. 3. 3 Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Abstract
OBJECTIVE: The objective of this study was to determine the characteristics of prostate cancer foci missed on 3-T multiparametric MRI performed with an endorectal coil. MATERIALS AND METHODS: The MRI examinations of 122 patients who underwent 3-T multiparametric MRI of the prostate with an endorectal coil were compared with whole-mount histopathology obtained after radical prostatectomy. The mean age of the patients was 60.6 years (SD, 7.6 years), and the mean prostate-specific antigen value was 7.2 ng/mL (SD, 5.9 ng/mL). The clinical, multiparametric MRI (i.e., T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging), and histopathologic features were obtained. After an independent review, two blinded genitourinary radiologists matched each case with a genitourinary pathologist. A structured reporting system was used to classify the multiparametric MRI features of each MRI-detected lesion. A chi-square analysis was performed for categoric variables, and the t test was performed for continuous variables. RESULTS: On whole-mount histopathology, 285 prostate cancer foci were detected in 122 patients. Of the 285 cancer foci detected at histopathology, 153 (53.3%) were missed on MRI and 132 (46.7%) were detected on MRI. Of the missed lesions, 75.2% were low-grade prostate cancer. Multiparametric MRI had a significantly higher sensitivity for prostate cancer foci 1 cm or larger than for subcentimeter foci (81.1% vs 18.9%, respectively; p < 0.001), for lesions with a Gleason score of 7 or greater than for lesions with a Gleason score of 6 (72.7% vs 27.3%; p < 0.01), and for index lesions than for satellite lesions (80.3% vs 20.8%; p < 0.01). The 3-T multiparametric MRI examinations showed a higher detection rate for lesions in the midgland or base of the gland compared with lesions in the apex (52.3% vs 22.0%, respectively; p < 0.01). CONCLUSION: Compared with the prostate cancer lesions that were detected on multiparametric MRI, the prostate cancer lesions that were missed were significantly smaller, were more likely to be low-grade lesions (i.e., Gleason score of 6), were more commonly satellite lesions, and were more likely to be located in the prostatic apex.
OBJECTIVE: The objective of this study was to determine the characteristics of prostate cancer foci missed on 3-T multiparametric MRI performed with an endorectal coil. MATERIALS AND METHODS: The MRI examinations of 122 patients who underwent 3-T multiparametric MRI of the prostate with an endorectal coil were compared with whole-mount histopathology obtained after radical prostatectomy. The mean age of the patients was 60.6 years (SD, 7.6 years), and the mean prostate-specific antigen value was 7.2 ng/mL (SD, 5.9 ng/mL). The clinical, multiparametric MRI (i.e., T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging), and histopathologic features were obtained. After an independent review, two blinded genitourinary radiologists matched each case with a genitourinary pathologist. A structured reporting system was used to classify the multiparametric MRI features of each MRI-detected lesion. A chi-square analysis was performed for categoric variables, and the t test was performed for continuous variables. RESULTS: On whole-mount histopathology, 285 prostate cancer foci were detected in 122 patients. Of the 285 cancer foci detected at histopathology, 153 (53.3%) were missed on MRI and 132 (46.7%) were detected on MRI. Of the missed lesions, 75.2% were low-grade prostate cancer. Multiparametric MRI had a significantly higher sensitivity for prostate cancer foci 1 cm or larger than for subcentimeter foci (81.1% vs 18.9%, respectively; p < 0.001), for lesions with a Gleason score of 7 or greater than for lesions with a Gleason score of 6 (72.7% vs 27.3%; p < 0.01), and for index lesions than for satellite lesions (80.3% vs 20.8%; p < 0.01). The 3-T multiparametric MRI examinations showed a higher detection rate for lesions in the midgland or base of the gland compared with lesions in the apex (52.3% vs 22.0%, respectively; p < 0.01). CONCLUSION: Compared with the prostate cancer lesions that were detected on multiparametric MRI, the prostate cancer lesions that were missed were significantly smaller, were more likely to be low-grade lesions (i.e., Gleason score of 6), were more commonly satellite lesions, and were more likely to be located in the prostatic apex.
Entities:
Keywords:
multiparametric prostate MRI; prostate cancer
Authors: Caroline M A Hoeks; Jelle O Barentsz; Thomas Hambrock; Derya Yakar; Diederik M Somford; Stijn W T P J Heijmink; Tom W J Scheenen; Pieter C Vos; Henkjan Huisman; Inge M van Oort; J Alfred Witjes; Arend Heerschap; Jurgen J Fütterer Journal: Radiology Date: 2011-10 Impact factor: 11.105
Authors: Hari Trivedi; Baris Turkbey; Ardeshir R Rastinehad; Compton J Benjamin; Marcelino Bernardo; Thomas Pohida; Vijay Shah; Maria J Merino; Bradford J Wood; W Marston Linehan; Aradhana M Venkatesan; Peter L Choyke; Peter A Pinto Journal: Urology Date: 2012-01 Impact factor: 2.649
Authors: Andrew B Rosenkrantz; Fang-Ming Deng; Sooah Kim; Ruth P Lim; Nicole Hindman; Thais C Mussi; Bradley Spieler; Jason Oaks; James S Babb; Jonathan Melamed; Samir S Taneja Journal: AJR Am J Roentgenol Date: 2012-10 Impact factor: 3.959
Authors: A E Wefer; H Hricak; D B Vigneron; F V Coakley; Y Lu; J Wefer; U Mueller-Lisse; P R Carroll; J Kurhanewicz Journal: J Urol Date: 2000-08 Impact factor: 7.450
Authors: Hashim U Ahmed; Richard G Hindley; Louise Dickinson; Alex Freeman; Alex P Kirkham; Mahua Sahu; Rebecca Scott; Clare Allen; Jan Van der Meulen; Mark Emberton Journal: Lancet Oncol Date: 2012-04-17 Impact factor: 41.316
Authors: Wennuan Liu; Sari Laitinen; Sofia Khan; Mauno Vihinen; Jeanne Kowalski; Guoqiang Yu; Li Chen; Charles M Ewing; Mario A Eisenberger; Michael A Carducci; William G Nelson; Srinivasan Yegnasubramanian; Jun Luo; Yue Wang; Jianfeng Xu; William B Isaacs; Tapio Visakorpi; G Steven Bova Journal: Nat Med Date: 2009-04-12 Impact factor: 53.440
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: Alan Priester; Shyam Natarajan; Pooria Khoshnoodi; Daniel J Margolis; Steven S Raman; Robert E Reiter; Jiaoti Huang; Warren Grundfest; Leonard S Marks Journal: J Urol Date: 2016-07-30 Impact factor: 7.450
Authors: J V Hegde; D J Margolis; P-C Wang; R E Reiter; J Huang; M L Steinberg; M Kamrava Journal: Prostate Cancer Prostatic Dis Date: 2017-01-31 Impact factor: 5.554
Authors: R Diamand; M Oderda; W Al Hajj Obeid; S Albisinni; R Van Velthoven; G Fasolis; G Simone; M Ferriero; J-B Roche; T Piechaud; A Pastore; A Carbone; G Fiard; J-L Descotes; G Marra; P Gontero; E Altobelli; R Papalia; P Kumar; D Eldred-Evans; A Giacobbe; G Muto; V Lacetera; V Beatrici; T Roumeguere; A Peltier Journal: World J Urol Date: 2019-01-16 Impact factor: 4.226
Authors: Neema Jamshidi; Daniel J Margolis; Steven Raman; Jiaoti Huang; Robert E Reiter; Michael D Kuo Journal: Radiology Date: 2017-04-28 Impact factor: 11.105
Authors: Cheyenne Williams; Michael Ahdoot; Michael A Daneshvar; Christian Hague; Andrew R Wilbur; Patrick T Gomella; Joanna Shih; Nabila Khondakar; Nitin Yerram; Sherif Mehralivand; Sandeep Gurram; Minhaj Siddiqui; Paul Pinsky; Howard Parnes; Maria Merino; Bradford Wood; Baris Turkbey; Peter A Pinto Journal: J Urol Date: 2021-08-26 Impact factor: 7.450
Authors: Fabian Tollens; Niklas Westhoff; Jost von Hardenberg; Sven Clausen; Michael Ehmann; Frank G Zöllner; Anne Adlung; Dominik F Bauer; Stefan O Schoenberg; Dominik Nörenberg Journal: Radiologe Date: 2021-07-12 Impact factor: 0.635