Charlotte Christophe1, Sarah Montagne2, Stéphanie Bourrelier1, Morgan Roupret3, Eric Barret4, François Rozet4, Eva Comperat5, Jean François Coté6, Olivier Lucidarme1, Olivier Cussenot7, Benjamin Granger8, Raphaële Renard-Penna9. 1. Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France. 2. Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Academic Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France. 3. Academic Department of Urology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France. 4. Montsouris Institute, Urology Department, Paris, F-75014, France. 5. Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France; Academic Department of Pathology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France. 6. Academic Department of Pathology, Hôpital Pitié-Salpetrière, Assistance Publique des Hôpitaux de Paris, Paris, France. 7. Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France; Academic Department of Urology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France. 8. Department of Public Health, Pitié-Salpétrière Academic Hospital, AP-HP, Sorbonne Universités, AP-HP, CIC-P 1421, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR 1136, CIC-1421, Hôpital Pitié Salpêtrière, AP-HP, Paris, France. 9. Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Academic Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France. Electronic address: raphaele.renardpenna@aphp.fr.
Abstract
PURPOSE: The value of adding dynamic contrast-enhanced (DCE) imaging to T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to improve the detection and staging of prostate cancer (PCa) is unclear. The aim of this retrospective study was to compare the diagnostic performance of non-contrast biparametric MRI (bpMRI) with multiparametric MRI (mpMRI), for local staging of PCa. METHODS: Ninety-two patients who underwent prostate MRI on a 3-Tesla MRI system before radical prostatectomy for PCa were included retrospectively. Four readers independently assigned a Likert score (ranging from 1 to 5) for predicting extra-prostatic extension (EPE) on T2W + DWI (bpMRI) and then on T2W + DWI + DCE imaging (mpMRI). MRI-based staging results were compared with radical prostatectomy histology. A prediction of EPE generalized linear mixed model was used to assess the added-value of DCE and discriminative power of staging accuracy by area under the receiver-operating curve (AUC ROC). RESULTS: AUC was not significantly improved by DCE (mpMRI, AUC = 0.73 [95%CI: 0.655‒0.827] vs. bpMRI, AUC = 0.76 [95%CI: 0.681‒0.846]). After applying a selection procedure, only MRI criteria were retained in a multivariate model. The following criteria were significantly associated with local extension: localization in the peripheral zone (p < 0.001), maximal diameter of the lesion (<0.0001), curvilinear capsular contact on T2W (p < 0.0001), capsular irregularity on T2W (p < 0.0001), bulging on T2W (p < 0.001) and seminal vesicle hypo-signal (p < 0.001). CONCLUSION: Use of bpMRI did not result in a decrease in local staging accuracy.
PURPOSE: The value of adding dynamic contrast-enhanced (DCE) imaging to T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to improve the detection and staging of prostate cancer (PCa) is unclear. The aim of this retrospective study was to compare the diagnostic performance of non-contrast biparametric MRI (bpMRI) with multiparametric MRI (mpMRI), for local staging of PCa. METHODS: Ninety-two patients who underwent prostate MRI on a 3-Tesla MRI system before radical prostatectomy for PCa were included retrospectively. Four readers independently assigned a Likert score (ranging from 1 to 5) for predicting extra-prostatic extension (EPE) on T2W + DWI (bpMRI) and then on T2W + DWI + DCE imaging (mpMRI). MRI-based staging results were compared with radical prostatectomy histology. A prediction of EPE generalized linear mixed model was used to assess the added-value of DCE and discriminative power of staging accuracy by area under the receiver-operating curve (AUC ROC). RESULTS: AUC was not significantly improved by DCE (mpMRI, AUC = 0.73 [95%CI: 0.655‒0.827] vs. bpMRI, AUC = 0.76 [95%CI: 0.681‒0.846]). After applying a selection procedure, only MRI criteria were retained in a multivariate model. The following criteria were significantly associated with local extension: localization in the peripheral zone (p < 0.001), maximal diameter of the lesion (<0.0001), curvilinear capsular contact on T2W (p < 0.0001), capsular irregularity on T2W (p < 0.0001), bulging on T2W (p < 0.001) and seminal vesicle hypo-signal (p < 0.001). CONCLUSION: Use of bpMRI did not result in a decrease in local staging accuracy.
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