OBJECTIVES: To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.
METHODS: One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n = 71) or 3 T (n = 104), with (n = 58) or without (n = 117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.
RESULTS: Readers identified 192-214/362 cancers, with 130-155 false positives. Detection rates for tumours of < 0.5 cc (cm3), 0.5-2 cc and >2 cc were 33-45/155 (21-29 %), 15-19/35 (43-54 %) and 8-9/12 (67-75 %) for Gleason ≤6, 17/27 (63 %), 42-45/51 (82-88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P < 0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P < 0.005) and aggressiveness of tumours (P < 0.00001).
CONCLUSIONS: Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.
Written by:
Bratan F, Niaf E, Melodelima C, Chesnais AL, Souchon R, Mège-Lechevallier F, Colombel M, Rouvière O. Are you the author?
Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69437, France.
Reference: Eur Radiol. 2013 Mar 15. Epub ahead of print.
doi: 10.1007/s00330-013-2795-0
PubMed Abstract
PMID: 23494494
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