Methods: Patients where post-HIFU DCE-MRI was followed within 3 months by ultrasound-guided transrectal biopsy were selected from a local database. 26 patients met the study inclusion criteria. Serial PSA levels following HIFU and post-HIFU follow up MRI were retrieved for each patient. Three radiologists unaware of other investigative results independently assessed post-HIFU MRI studies for the presence of cancer scoring on a four-point scale (1, no disease; 2, likely no disease; 3, likely residual disease; and 4, residual disease). Sensitivity, specificity and receiver operating characteristic (ROC) analysis was performed for each reader, post-HIFU PSA nadir and pre-biopsy PSA level thresholds of >0.2 and >0.5 ng ml-1.
Results: The sensitivity of DCE-MRI for detection of residual disease for the 3 readers ranged between 73% and 87%, and the specificity between 73% and 82%. There was good agreement between readers (κ = 0.69-0.77). The sensitivity and specificity of PSA thresholds was 60%-87% and 73%-100% respectively. The area under the ROC curve was greatest for pre-biopsy PSA (0.95).
Conclusion: DCE-MRI performed following whole-gland HIFU has similar sensitivity and specificity and ROC performance to serial PSA measurements for detection of residual or recurrent disease.
Written by:
Punwani S, Emberton M, Walkden M, Sohaib A, Freeman A, Ahmed H, Allen C, Kirkham A. Are you the author?
Department of Radiology, 2nd Floor Podium, University College London Hospital, 235 Euston Road, London NW1 2BU.
Reference: Br J Radiol. 2012 Jan 17. Epub ahead of print.
doi: 10.1259/bjr/61380797
PubMed Abstract
PMID: 22253342
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