OBJECTIVE: To examine the performance of T2- and diffusion-weighted (DW) magnetic resonance imaging (MRI) for detecting the index tumor in patients with prostate cancer.
To examine the agreement between MRI and histology when assessing tumor volume (TV) and overall tumor burden.
PATIENTS AND METHODS: The study included 199 consecutive patients with biopsy proven prostate cancer randomized to MRI prior to radical prostatectomy from December 2009 to July 2012. MRI-detected tumors (MRTs) were ranked from 1 to 3 according to decreasing volume and were compared with histologically detected tumors (HTs) ranked 1 to 3, and HT 1 = index tumor. Whole-mount section histology was used as a reference standard. The TVs of true-positive MRTs (MRTVs 1-3) were compared with the TVs found by histology (HTVs 1-3). All tumors were registered on a 30-sector map, and by classifying each sector as positive/negative, the rate of true-positive and -negative sectors was calculated.
RESULT: The detection rate for the HT 1 (index tumor) was 92%; HT 2, 45%; and HT 3, 37%. The MRTV 1-3 vs. the HTV 1-3 were 2.8 ml vs. 4.0 ml (index tumor, p< 0.001), 1.0 ml vs. 0.9 ml (tumor 2, p=0.413), and 0.6 ml vs. 0.5 ml (tumor 3, p=0.492). The rate of true-positive and -negative sectors was 50% and 88%, K=0.39.
CONCLUSION: A combination of T2w and DW MRI detects the index tumor in 92%, although MRI underestimates both TV and tumor burden compared to histology.
Written by:
Rud E, Klotz D, Rennesund K, Baco E, Berge V, Lien D, Svindland A, Lundeby E, Berg RE, Eri LM, Eggesbø HB. Are you the author?
Division of Diagnostics and Intervention, Department of Radiology and Nuclear Medicine, Oslo University Hospital, Aker.
Reference: BJU Int. 2014 Jan 21. Epub ahead of print.
doi: 10.1111/bju.12637
PubMed Abstract
PMID: 24447606
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