Serena Pullini1, Marco Andrea Signor2, Martina Pancot3, Chiara Zuiani4, Massimo Bazzocchi5, Sandro Fongione6, Rossano Girometti7. 1. Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, via Colugna, 50-33100 Udine, Italy. Electronic address: serepul@libero.it. 2. Department of Oncological Radiation Therapy, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Piazzale S. M. della Misericordia, 15-33100 Udine, Italy. Electronic address: signor.marco@aoud.sanita.fvg.it. 3. Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, via Colugna, 50-33100 Udine, Italy. Electronic address: martypancot@libero.it. 4. Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, via Colugna, 50-33100 Udine, Italy. Electronic address: zuiani.chiara@aoud.sanita.fvg.it. 5. Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, via Colugna, 50-33100 Udine, Italy. Electronic address: bazzocchi.massimo@aoud.sanita.fvg.it. 6. Department of Oncological Radiation Therapy, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Piazzale S. M. della Misericordia, 15-33100 Udine, Italy. Electronic address: fongione.sandro@aoud.sanita.fvg.it. 7. Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, via Colugna, 50-33100 Udine, Italy. Electronic address: rgirometti@sirm.org.
Abstract
PURPOSE: To investigate the impact of multiparametric magnetic resonance imaging (mpMRI) on risk group assessment of patients with prostate cancer (PCa) initially addressed to external beam radiation therapy (EBRT). MATERIALS AND METHODS: We prospectively performed mpMRI (3.0Tsystem) in 44 patients addressed to EBRT, using a multiparametric protocol (high-resolution multiplanar T2-weighted, diffusion-weighted and dynamic contrast-enhanced imaging). Risk group was assessed in accordance with the National comprehensive cancer network (NCCN) categories, by combining prostate-specific-antigen level, Gleason score and the T-stage as established by digital rectal examination (clinical risk assessment; c-RA) versus mpMRI (mpMRI-risk assessment; mpMRI-RA). The agreement between c-RA and mpMRI-RA was investigated using Cohen's kappa. RESULTS: Patients were included in very low/low risk, intermediate risk, high risk, very high risk and metastatic NCCN categories in 10 (22.7%), 18 (40.9%), 15 (34.1%), 1 (2.3%) and 0 cases using c-RA vs. 8 (18.2%), 14 (31.8%), 14 (31.8%), 4 (9.1%) and 4 (9.1%) cases using mpMRI-RA, respectively, with only moderate agreement (k=0.43). mpMRI-RA determined risk downgrading in 2/44 patients (4.5%), and risk upgrading in 16/44 patients (36.3%). After mpMRI, EBRT remained indicated in all patients. CONCLUSION: mpMRI changed clinical risk stratification in about 41% of patients with PCa, with potential impact on EBRT planning.
PURPOSE: To investigate the impact of multiparametric magnetic resonance imaging (mpMRI) on risk group assessment of patients with prostate cancer (PCa) initially addressed to external beam radiation therapy (EBRT). MATERIALS AND METHODS: We prospectively performed mpMRI (3.0Tsystem) in 44 patients addressed to EBRT, using a multiparametric protocol (high-resolution multiplanar T2-weighted, diffusion-weighted and dynamic contrast-enhanced imaging). Risk group was assessed in accordance with the National comprehensive cancer network (NCCN) categories, by combining prostate-specific-antigen level, Gleason score and the T-stage as established by digital rectal examination (clinical risk assessment; c-RA) versus mpMRI (mpMRI-risk assessment; mpMRI-RA). The agreement between c-RA and mpMRI-RA was investigated using Cohen's kappa. RESULTS:Patients were included in very low/low risk, intermediate risk, high risk, very high risk and metastatic NCCN categories in 10 (22.7%), 18 (40.9%), 15 (34.1%), 1 (2.3%) and 0 cases using c-RA vs. 8 (18.2%), 14 (31.8%), 14 (31.8%), 4 (9.1%) and 4 (9.1%) cases using mpMRI-RA, respectively, with only moderate agreement (k=0.43). mpMRI-RA determined risk downgrading in 2/44 patients (4.5%), and risk upgrading in 16/44 patients (36.3%). After mpMRI, EBRT remained indicated in all patients. CONCLUSION: mpMRI changed clinical risk stratification in about 41% of patients with PCa, with potential impact on EBRT planning.
Authors: Rossano Girometti; Martina Pancot; Marco Andrea Signor; Martina Urbani; Luca Balestreri; Chiara Zuiani Journal: Radiol Med Date: 2018-05-12 Impact factor: 3.469
Authors: Felipe Couñago; Gemma Sancho; Violeta Catalá; Diana Hernández; Manuel Recio; Sara Montemuiño; Jhonathan Alejandro Hernández; Antonio Maldonado; Elia Del Cerro Journal: World J Clin Oncol Date: 2017-08-10
Authors: Hugh Harvey; Matthew R Orton; Veronica A Morgan; Chris Parker; David Dearnaley; Cyril Fisher; Nandita M deSouza Journal: Br J Radiol Date: 2017-01-05 Impact factor: 3.039