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Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI.

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Title: Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI.
Authors: Bloch BN (AUTHOR), Genega EM (AUTHOR), Costa DN (AUTHOR), Pedrosa I (AUTHOR), Smith MP (AUTHOR), Kressel HY (AUTHOR), Ngo L (AUTHOR), Sanda MG (AUTHOR), Dewolf WC (AUTHOR), Rofsky NM (AUTHOR), Bloch, B Nicolas1 (AUTHOR), Genega, Elizabeth M (AUTHOR), Costa, Daniel N (AUTHOR), Pedrosa, Ivan (AUTHOR), Smith, Martin P (AUTHOR), Kressel, Herbert Y (AUTHOR), Ngo, Long (AUTHOR), Sanda, Martin G (AUTHOR), Dewolf, William C (AUTHOR), Rofsky, Neil M (AUTHOR)
Source: European Radiology. Oct2012, Vol. 22 Issue 10, p2201-2210. 10p.
Abstract: Objectives: To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T for determining extracapsular extension (ECE) of prostate cancer.Methods: In this IRB-approved study, ERC 3-T MRI of the prostate was performed in 108 patients before radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analysed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating characteristic curve.Results: The overall sensitivity, specificity, positive predictive value and negative predictive value for ECE were 75 %, 92 %, 79 % and 91 %, respectively. Diagnostic accuracy for staging was 86 %, 80 % and 91 % for all readers, experienced and less experienced readers, respectively.Conclusions: ERC 3-T MRI of the prostate combining DCE and T2W imaging is an accurate pretherapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience.Key Points: • Endorectal coil (ERC) magnetic resonance imaging is widely used for imaging prostatic disease. • ERC 3-T MRI is reasonably accurate for local prostate cancer staging. • High diagnostic accuracy is achievable across different levels of reader experience. • MRI facilitates therapeutic decisions in patients with prostate cancer. [ABSTRACT FROM AUTHOR]
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Abstract:<bold>Objectives: </bold>To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T for determining extracapsular extension (ECE) of prostate cancer.<bold>Methods: </bold>In this IRB-approved study, ERC 3-T MRI of the prostate was performed in 108 patients before radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analysed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating characteristic curve.<bold>Results: </bold>The overall sensitivity, specificity, positive predictive value and negative predictive value for ECE were 75 %, 92 %, 79 % and 91 %, respectively. Diagnostic accuracy for staging was 86 %, 80 % and 91 % for all readers, experienced and less experienced readers, respectively.<bold>Conclusions: </bold>ERC 3-T MRI of the prostate combining DCE and T2W imaging is an accurate pretherapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience.<bold>Key Points: </bold>• Endorectal coil (ERC) magnetic resonance imaging is widely used for imaging prostatic disease. • ERC 3-T MRI is reasonably accurate for local prostate cancer staging. • High diagnostic accuracy is achievable across different levels of reader experience. • MRI facilitates therapeutic decisions in patients with prostate cancer. [ABSTRACT FROM AUTHOR]
ISSN:09387994
DOI:10.1007/s00330-012-2475-5