Aradhana M Venkatesan1, Eniola Mudairu-Dawodu2, Cihan Duran3, R Jason Stafford4, Yuanqing Yan5, Wei Wei5, Vikas Kundra1,6. 1. Department of Diagnostic Radiology, Division of Diagnostic Radiology, MD Anderson Cancer Center, Houston, TX, USA. 2. West Houston Radiology Associates, 21216 North West Freeway, Suite 2200, Cypress, TX, USA. 3. Department of Diagnostic and Interventional Imaging, UT Houston, 6411 Fannin Street, Suite J2.222, Houston, TX, USA. Cihan.duran@uth.tmc.edu. 4. Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA. 6. Department of Cancer Systems Imaging, Division of Diagnostic Radiology, MD Anderson Cancer Center, Houston, TX, USA.
Abstract
BACKGROUND: The utility of multiparametric MRI (mpMRI) in detecting suspected local recurrence post radical prostatectomy (RP) may be associated with PSA and Gleason grade. The purpose of the study was to evaluate the likelihood of detecting locally recurrent prostate cancer utilizing mpMRI in patients with suspected recurrence following radical prostatectomy (RP) parsed by PSA and Gleason grade. METHODS: One hundred ninety five patients with suspected local recurrence were imaged on a 1.5 T MRI with torso array and endorectal coil in this retrospective study. mpMRI interpretations were stratified by PSA and lower (Gleason < 7) vs. higher grade tumors (Gleason 8-10). Recursive partitioning was used to determine whether mpMRI interpretations could be classified as positive or negative. RESULTS: The majority of mpMRI interpretations in patients with lower Gleason grade tumors and PSA < 0.5 ng/mL were negative (68/78, 87.2%, p = 0.004). The majority of mpMRI interpretations in patients with higher Gleason grade tumors and PSA > 1.5 ng/mL were positive (8/9, 88.9%, p = 0.003). Findings were corroborated by recursive partitioning, which identified a PSA = 0.5 ng/ml in patients with lower grade tumors and a PSA = 1.5 ng/mL in patients with higher grade tumors as differentiating negative and positive mpMRIs. CONCLUSION: In the setting of suspected recurrence after RP, mpMRI results are associated with PSA and Gleason grade, both of which can help guide when mpMRI may find utility. mpMRI is likely to be low diagnostic yield and negative for recurrence (87%) in the setting of lower Gleason grade tumors and PSA < 0.5 ng/mL. mpMRI is likely to be of low diagnostic value and positive for recurrence (89%) in the setting of PSA > 1.5 ng/mL and higher grade tumors; in this case, mpMRI findings may be more useful for directing biopsy and local therapy. Between these extremes, PSA > 0.5 ng/mL and lower grade tumors or PSA < 1.5 ng/mL and higher grade tumors, mpMRI results are less predictable, suggesting greater diagnostic value for detecting recurrence post prostatectomy.
BACKGROUND: The utility of multiparametric MRI (mpMRI) in detecting suspected local recurrence post radical prostatectomy (RP) may be associated with PSA and Gleason grade. The purpose of the study was to evaluate the likelihood of detecting locally recurrent prostate cancer utilizing mpMRI in patients with suspected recurrence following radical prostatectomy (RP) parsed by PSA and Gleason grade. METHODS: One hundred ninety five patients with suspected local recurrence were imaged on a 1.5 T MRI with torso array and endorectal coil in this retrospective study. mpMRI interpretations were stratified by PSA and lower (Gleason < 7) vs. higher grade tumors (Gleason 8-10). Recursive partitioning was used to determine whether mpMRI interpretations could be classified as positive or negative. RESULTS: The majority of mpMRI interpretations in patients with lower Gleason grade tumors and PSA < 0.5 ng/mL were negative (68/78, 87.2%, p = 0.004). The majority of mpMRI interpretations in patients with higher Gleason grade tumors and PSA > 1.5 ng/mL were positive (8/9, 88.9%, p = 0.003). Findings were corroborated by recursive partitioning, which identified a PSA = 0.5 ng/ml in patients with lower grade tumors and a PSA = 1.5 ng/mL in patients with higher grade tumors as differentiating negative and positive mpMRIs. CONCLUSION: In the setting of suspected recurrence after RP, mpMRI results are associated with PSA and Gleason grade, both of which can help guide when mpMRI may find utility. mpMRI is likely to be low diagnostic yield and negative for recurrence (87%) in the setting of lower Gleason grade tumors and PSA < 0.5 ng/mL. mpMRI is likely to be of low diagnostic value and positive for recurrence (89%) in the setting of PSA > 1.5 ng/mL and higher grade tumors; in this case, mpMRI findings may be more useful for directing biopsy and local therapy. Between these extremes, PSA > 0.5 ng/mL and lower grade tumors or PSA < 1.5 ng/mL and higher grade tumors, mpMRI results are less predictable, suggesting greater diagnostic value for detecting recurrence post prostatectomy.
Authors: Andrew J Stephenson; Michael W Kattan; James A Eastham; Zohar A Dotan; Fernando J Bianco; Hans Lilja; Peter T Scardino Journal: J Clin Oncol Date: 2006-08-20 Impact factor: 44.544
Authors: Misop Han; Alan W Partin; Marianna Zahurak; Steven Piantadosi; Johnathan I Epstein; Patrick C Walsh Journal: J Urol Date: 2003-02 Impact factor: 7.450
Authors: Thomas De Perrot; Christine Sadjo Zoua; Carl G Glessgen; Diomidis Botsikas; Lena Berchtold; Rares Salomir; Sophie De Seigneux; Harriet C Thoeny; Jean-Paul Vallée Journal: J Clin Med Date: 2022-03-30 Impact factor: 4.241