Filippo Pesapane1, Chloë Standaert2, Pieter De Visschere3, Geert Villeirs4. 1. Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy. Electronic address: filippo.pesapane@unimi.it. 2. Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Corneel Heymanslaan 10, 9000 Gent, Belgium. 3. Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Corneel Heymanslaan 10, 9000 Gent, Belgium. Electronic address: pieter.devisschere@uzgent.be. 4. Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Corneel Heymanslaan 10, 9000 Gent, Belgium. Electronic address: geert.villeirs@ugent.be.
Abstract
OBJECTIVES: To determine the prevalence and predictive value of a series of commonly used MRI criteria for posterolateral extraprostatic extension (EPE) of prostate cancer (PCa). METHODS: The presence of EPE in index lesions visible on prebiopsy mpMRI (T2w, DWI and DCE on a 3 Tesla-system) of biopsy-proven PCa patients was blindly assessed retrospectively by two radiologists with 8- and 17-years of experience on the basis of 8 commonly used staging criteria. Radical prostatectomy was used as standard of reference. The prevalences and positive predictive values (PPV) of all criteria were calculated for each reader separately and averaged for the two readers together. Cohen's K and percentage of agreement were used to assess the interobserver agreement. RESULTS: In 51 patients (mean age: 63 years; mean PSA: 17.2 ng/ml), tumor-capsule contact was the most prevalent sign (average 56,9%), but with the lowest PPV (average 51.9%), although increasing with broader capsular contact (56.5% if ≥10 mm; 87.5% if ≥20 mm; 100% if ≥25 mm). "Early signs" of EPE such as bulging, capsular disruption and unsharp prostatic margin showed a prevalence of 11.8%-18.6% on average, with 74.5%-86.3% of agreement; the average PPV range was 69.0%-75.0%. "Late signs" of EPE such as irregular prostatic contour, periprostatic fat infiltration, rectoprostatic angle obliteration and periprostatic mass showed a prevalence of 2.9%-8.8% on average, with 86.3%-94.1% of agreement; the average PPVs ranged between 85.7% and 100%. CONCLUSIONS: "Early" signs of EPE show high prevalences but low PPVs, while "late" signs show lower prevalences but higher PPVs. MRI-staging following this chronological concept can standardize morphologic staging and decrease the existing multi-reader variability.
OBJECTIVES: To determine the prevalence and predictive value of a series of commonly used MRI criteria for posterolateral extraprostatic extension (EPE) of prostate cancer (PCa). METHODS: The presence of EPE in index lesions visible on prebiopsy mpMRI (T2w, DWI and DCE on a 3 Tesla-system) of biopsy-proven PCapatients was blindly assessed retrospectively by two radiologists with 8- and 17-years of experience on the basis of 8 commonly used staging criteria. Radical prostatectomy was used as standard of reference. The prevalences and positive predictive values (PPV) of all criteria were calculated for each reader separately and averaged for the two readers together. Cohen's K and percentage of agreement were used to assess the interobserver agreement. RESULTS: In 51 patients (mean age: 63 years; mean PSA: 17.2 ng/ml), tumor-capsule contact was the most prevalent sign (average 56,9%), but with the lowest PPV (average 51.9%), although increasing with broader capsular contact (56.5% if ≥10 mm; 87.5% if ≥20 mm; 100% if ≥25 mm). "Early signs" of EPE such as bulging, capsular disruption and unsharp prostatic margin showed a prevalence of 11.8%-18.6% on average, with 74.5%-86.3% of agreement; the average PPV range was 69.0%-75.0%. "Late signs" of EPE such as irregular prostatic contour, periprostatic fat infiltration, rectoprostatic angle obliteration and periprostatic mass showed a prevalence of 2.9%-8.8% on average, with 86.3%-94.1% of agreement; the average PPVs ranged between 85.7% and 100%. CONCLUSIONS: "Early" signs of EPE show high prevalences but low PPVs, while "late" signs show lower prevalences but higher PPVs. MRI-staging following this chronological concept can standardize morphologic staging and decrease the existing multi-reader variability.
Authors: Marco Gatti; Riccardo Faletti; Francesco Gentile; Enrico Soncin; Giorgio Calleris; Alberto Fornari; Marco Oderda; Alessandro Serafini; Giulio Antonino Strazzarino; Elena Vissio; Laura Bergamasco; Stefano Cirillo; Mauro Giulio Papotti; Paolo Gontero; Paolo Fonio Journal: Eur Radiol Date: 2022-03-15 Impact factor: 7.034
Authors: Graham R Hale; Filippo Pesapane; Sheng Xu; Ivane Bakhutashvili; Neil Glossop; Baris Turkbey; Peter A Pinto; Bradford J Wood Journal: Eur Radiol Exp Date: 2020-04-16