Accuracy of endorectal Magnetic Resonance Imaging (MRI) and Dynamic Contrast Enhanced-MRI (DCE-MRI) in the preoperative local staging of prostate cancer

2012 ◽  
Vol 79 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Alessandro Baccos ◽  
Riccardo Schiavina ◽  
Ziv Zukerman ◽  
Fiorenza Busato ◽  
Caterina Gaudianol ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Diagnostic Accuracy ◽  
Resonance Imaging ◽  
Mr Images ◽  
Dce Mri ◽  
Local Staging ◽  
Magnetic Resonance Imaging Mri

Background The proper management of newly diagnosed prostate cancer (PCa) requires the choice of the appropriate treatment plan. A crucial factor is the accurate evaluation of the tumor local extension. The Magnetic Resonance Imaging (MRI) plays an important role in the local staging of prostate cancer, although its use in clinical practice is widely debated. Therefore, the purpose of our study was to evaluate the diagnostic accuracy of T2-weighted MR imaging in association with DCE-MRI, performed using an endorectal coil, in preoperative local staging of patients with prostate cancer, by using the histopathologic findings as the reference standard. Materials and Methods From April 2010 to May 2011, 65 patients (mean age, 65 years; range, 51–77 years) with clinical localized PCa, underwent radical prostatectomy at our institution, performed by 2 experienced surgeons. All patients were prospectively evaluated with eMRI in association with DCE-MRI prior to radical prostatectomy. In all patients MRI was performed at least 6 weeks after biopsy and within 2 weeks before Radical Prostatectomy (RP). Histologic analysis was our diagnostic “gold standard”. To ensure that the histopathological findings matched with MR images, the assessment of radiological images and the RP specimens were performed dividing the prostate in 14 regions. Results First, we performed a “per-patient” analysis, considering the entire prostate as a single region. Then, we performed a “per-emigland” analysis, finally a “per-region” analysis. The sensitivity, specificity, PPV, NPV and AUC in predicting ECE in the analysis “per-emigland” were respectively 66.7, 95.7, 66.7, 95.7, 0.824. The evaluation of SVI reported similar results: 62.5, 97.5, 62.5, 97.5, 0.797. DCE-MRI did not improve the diagnostic accuracy of T1-T2-weighted MR images in the evaluation of ECE or SVI. Conclusions T1-, T2-weighted MRI adds important information regarding the preoperative local staging of PCa. DCE-MRI does not improve the diagnostic accuracy of MRI in the local staging of PCa.

Multiparametric Magnetic Resonance Imaging of the Prostate for Tumour Detection and Local Staging: Imaging in 1.5T and Histopathologic Correlation

2017 ◽  
Vol 68 (4) ◽  
pp. 379-386 ◽  
Author(s):  
Dimitra Loggitsi ◽  
Anastasios Gyftopoulos ◽  
Nikolaos Economopoulos ◽  
Aikaterini Apostolaki ◽  
Theodoros Kalogeropoulos ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Tumour Detection ◽  
Dce Mri ◽  
Imaging Results ◽  
Local Staging ◽  
High Negative Predictive Value ◽  
Magnetic Resonance Imaging Mri ◽  
Weighted Sequences

Purpose The study sought to prospectively evaluate which technique among T2-weighted images, dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), diffusion-weighted (DW) MRI, or a combination of the 2, is best suited for prostate cancer detection and local staging. Methods Twenty-seven consecutive patients with biopsy-proven adenocarcinoma of the prostate underwent MRI on a 1.5T scanner with a surface phased-array coil prior radical prostatectomy. Combined anatomical and functional imaging was performed with the use of T2-weighted sequences, DCE MRI, and DW MRI. We compared the imaging results with whole mount histopathology. Results For the multiparametric approach, significantly higher sensitivity values, that is, 53% (95% confidence interval [CI]: 41.0-64.1) were obtained as compared with each modality alone or any combination of the 3 modalities ( P < .05). The specificity for this multiparametric approach, being 90.3% (95% CI: 86.3-93.3) was not significantly higher ( P < .05) as compared with the values of the combination of T2+DCE MRI, DW+DCE MRI, or DCE MRI alone. Among the 3 techniques, DCE had the best performance for tumour detection in both the peripheral and the transition zone. High negative predictive value rates (>86%) were obtained for both tumour detection and local staging. Conclusions The combination of T2-weighted sequences, DCE MRI, and DW MRI yields higher diagnostic performance for tumour detection and local staging than can any of these techniques alone or even any combination of them.

scholarly journals Influence of Varying Assessment Parameters on the Diagnostic Accuracy of Magnetic Resonance Imaging in the Local Staging of Prostate Cancer

2015 ◽  
Vol 96 (3) ◽  
pp. 309-314 ◽  
Author(s):  
Martin H. Umbehr ◽  
Martin Lüscher ◽  
Roger Hunziker ◽  
Florian Falkner ◽  
Peter J. Wild ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Resonance Imaging ◽  
Local Staging

scholarly journals Prostate Cancers Detected by Magnetic Resonance Imaging–Targeted Biopsies Have a Higher Percentage of Gleason Pattern 4 Component and Are Less Likely to Be Upgraded in Radical Prostatectomies

2018 ◽  
Vol 143 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Yani Zhao ◽  
Fang-Ming Deng ◽  
Hongying Huang ◽  
Peng Lee ◽  
Hebert Lepor ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Targeted Biopsy ◽  
Resonance Imaging ◽  
Gleason Pattern ◽  
Magnetic Resonance Imaging Mri ◽  
Prostate Cancers ◽  
Targeted Biopsies

Context.— In Gleason score (GS) 7 prostate cancers, the quantity of Gleason pattern 4 (GP 4) is an important prognostic factor and influences treatment decisions. Magnetic resonance imaging (MRI)–targeted biopsy has been increasingly used in clinical practice. Objective.— To investigate whether MRI-targeted biopsy may detect GS 7 prostate cancer with greater GP 4 quantity, and whether it improves biopsy/radical prostatectomy GS concordance. Design.— A total of 243 patients with paired standard and MRI-targeted biopsies with cancer in either standard or targeted or both were studied, 65 of whom had subsequent radical prostatectomy. The biopsy findings, including GS and tumor volume, were correlated with the radical prostatectomy findings. Results.— More prostate cancers detected by MRI-targeted biopsy were GS 7 or higher. Mean GP 4 percentage in GS 7 cancers was 31.0% ± 29.3% by MRI-targeted biopsy versus 25.1% ± 29.5% by standard biopsy. A total of 122 of 218 (56.0%) and 96 of 217 (44.2%) prostate cancers diagnosed on targeted biopsy and standard biopsy, respectively, had a GP 4 of 10% or greater (P = .01). Gleason upgrading was seen in 12 of 59 cases (20.3%) from MRI-targeted biopsy and in 24 of 57 cases (42.1%) from standard biopsy (P = .01). Gleason upgrading correlated with the biopsy cancer volume inversely and GP 4 of 30% or less in standard biopsy. Such correlation was not found in MRI-targeted biopsy. Conclusions.— Magnetic resonance imaging–targeted biopsy may detect more aggressive prostate cancers and reduce the risk of Gleason upgrading in radical prostatectomy. This study supports a potential role for MRI-targeted biopsy in the workup of prostate cancer and inclusion of percentage of GP 4 in prostate biopsy reports.

scholarly journals Multiparametric magnetic resonance imaging for pre-treatment local staging of prostate cancer: A Cancer Care Ontario clinical practice guideline

2016 ◽  
Vol 10 (9-10) ◽  
pp. 332 ◽  
Author(s):  
Jennifer Salerno ◽  
Antonio Finelli ◽  
Chris Morash ◽  
Scott C. Morgan ◽  
Nicholas Power ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Patient Outcomes ◽  
Clinical Staging ◽  
Resonance Imaging ◽  
Mri Staging ◽  
Local Staging ◽  
Pre Treatment

Introduction: The utility of T2-weighted magnetic resonance imaging (MRI) in the local staging of prostate cancer is controversial. Due to the success of multiparametric MRI in cancer localization, there is renewed interested in MRI (± functional sequences) for local staging. Guidance on pre-treatment local staging of prostate cancer by MRI was developed using systematic review methodology and expert consultation.Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and other databases were searched to identify studies comparing: (1) MRI staging vs. radical prostatectomy staging on diagnostic accuracy outcomes; and (2) MRI staging vs. routine clinical staging on clinical and patient outcomes. Studies meeting inclusion criteria were synthesized by outcome and sensitivity/ specificity analysis by tumour location was performed. Evidence quality of included studies was assessed and considered in recommendation formulation.Results: The literature search identified 2510 citations; 62 studies were included. Analysis of MRI ≥1.5 T plus endorectal coil (ER) (± functional sequences) in the detection of extraprostatic extension or seminal vesicle invasion showed modest sensitivities (≥50%) and excellent specificities (>85%) among patients scheduled for radical prostatectomy. MRI upstaging was shown in 20/21 studies, with large variation in correctness (11‒85%). Scarcity of clinical and patient outcomes among studies limited synthesis and evaluation. Quality assessment found non-trivial biases.Conclusions: Modest imaging performance was shown for MRI (1.5 T + ER and 3 T ± ER) ± functional sequences in regards to sensitivity. Limitations in study design, reporting of clinical and patient outcomes, and the heterogeneous use of MRI tempered the strength of the recommendations.

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