Keywords:
Oncology, Pelvis, Genital / Reproductive system male, MR, Staging, Diagnostic procedure, Imaging sequences, Neoplasia
Authors:
B. Yagci, F. Ufuk, E. Sağtaş, P. Cakmak, D. HEREK, A. E. Zumrutbas, N. Sen Turk; Denizli/TR
DOI:
10.1594/ecr2018/C-0800
Results
Table 1 shows patient characteristics.
Histopathological workup revealed prostate cancer with ECE in 22 (32%) patients (13 patients with Gleason score 7,
and 9 patients with Gleason score ≥8).
Figures show mpMRI images of cases with ECE (Figure 1 and 2) and without ECE (Figure 3).
The accuracy of mpMRI was 81%,
with sensitivity of 86% and specificity of 79% for detection of ECE (Table 2).
The negative and positive predictive values were 93% and 66%,
respectively.
ECE rate was 91%,
in patients with mpMRI positive,
preoperative biopsy Gleason score ≥7,
and PSA density ≥0.20.
ECE was not detected in 95% of patients with mpMRI negative,
preoperative biopsy Gleason score 6,
and PSA density <0.20 (Table 3).
A chi-square test revealed a significant difference between risk groups (X2=25.846,
P<0.0001).
Table 1: Patient characteristics.
Patient characteristics (n=69)
|
Mean/Median
|
Range
|
Age
|
63 years
|
48 – 76 years
|
Serum PSA level
|
9.85 ng/ml
|
2.05 – 37.50 ng/ml
|
Prostate volume
|
46 cm3
|
15 – 129 cm3
|
PSA density
|
0.24
|
0.04 – 0.95
|
Interval between mpMRI and radical prostatectomy
|
26 days
|
3 – 178 days
|
Prostate biopsy history before MRI
|
n (%)
|
Biopsy results
|
n
|
Patients with a previous positive biopsy result *
|
42 (61%)
|
Gleason score 6
|
29
|
Gleason score ≥7
|
13
|
* Interval between biopsy and mpMRI
|
median,
8 weeks; range,
3 - 32 weeks
|
Patients with a previous negative biopsy result
(interval between biopsy and mpMRI ≥6 weeks)
|
12
(17%)
|
Gleason score 6
|
6
|
Gleason score ≥7
|
6
|
Biopsy naive patients
|
15
(22%)
|
Gleason score 6
|
9
|
Gleason score ≥7
|
6
|
Table 2. Performance of mpMRI with PIRADSv2,
using a 1.5T MRI system with a torso coil,
in the detection of extracapsular extension (ECE) of prostate cancer.
PIRADSv2
|
Radical prostatectomy
|
Total
|
ECE(+)
|
ECE(-)
|
mpMRI (+)
|
19
|
10
|
29
|
mpMRI (-)
|
3
|
37
|
40
|
Total
|
22
|
47
|
69
|
|
Sensitivity 86%
|
Specificity 79%
|
|