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J Magn Reson Imaging. 2017 Jun;45(6):1760-1770. doi: 10.1002/jmri.25515. Epub 2016 Oct 17.

Evaluation of extracapsular extension in prostate cancer using qualitative and quantitative multiparametric MRI.

Author information

1
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
3
Biostatistics and Clinical Epidemiology Center, Samsung Hospital, Seoul, Korea.

Abstract

PURPOSE:

To investigate the value of multiparametric magnetic resonance imaging (mpMRI) for extracapsular extension (ECE) in prostate cancer (PCa).

MATERIALS AND METHODS:

In all, 292 patients who received radical prostatectomy and underwent preoperative mpMRI at 3T were enrolled retrospectively. For determining the associations with ECE, the likelihood of ECE was assessed qualitatively on T2 -weighted imaging (T2 WI) and combined T2 WI and diffusion-weighted imaging (DWI) or dynamic contrast-enhanced imaging (DCEI). Quantitative MRI parameters were measured in PCa based on histopathological findings. Two models for detecting ECE including imaging and clinical parameters were developed using multivariate analysis: Model 1 excluding combined T2 WI and DWI and DCEI and Model 2 excluding combined T2 WI and DWI, and combined T2 WI and DCEI. Diagnostic performance of imaging parameters and models was evaluated using the area under the receiver operating characteristics curve (Az).

RESULTS:

For detecting ECE, the specificity, accuracy, and Az of combined T2 WI and DWI or DCEI were statistically better than those of T2 WI (P < 0.05), and all quantitative MRI parameters showed a statistical difference between the patients with and without ECE (P < 0.05). On multivariate analysis, significant independent markers in Model 1 were combined T2 WI and DWI, combined T2 WI and DCEI, and Ktrans (P < 0.05). In Model 2, significant markers were combined T2 WI and DWI and DCEI, Ktrans , Kep , and Ve (P < 0.05). The Az values of models 1 and 2 were 0.944 and 0.957, respectively.

CONCLUSION:

mpMRI may be useful to improve diagnostic accuracy of the models for determining the associations with ECE in PCa.

LEVEL OF EVIDENCE:

4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1760-1770.

KEYWORDS:

diagnostic accuracy; extracapsular extension; magnetic resonance imaging; prostate cancer

PMID:
27749009
DOI:
10.1002/jmri.25515
[Indexed for MEDLINE]

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