1
|
Sitharthan D, Kang S, Treacy PJ, Bird J, Alexander K, Karunaratne S, Leslie S, Chan L, Steffens D, Thanigasalam R. The Sensitivity and Specificity of Multiparametric Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Predicting Seminal Vesicle Invasion in Clinically Significant Prostate Cancer: A Multicenter Retrospective Study. J Clin Med 2024; 13:4424. [PMID: 39124692 PMCID: PMC11312943 DOI: 10.3390/jcm13154424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: The presence of seminal vesicle invasion (SVI) in prostate cancer (PCa) is associated with poorer postoperative outcomes. This study evaluates the predictive value of magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for SVI in PCa. Methods: This cohort study included consecutive robotic prostatectomy patients for PCa at three Australian tertiary referral centres between April 2016 and September 2022. MRI and PSMA PET/CT results, clinicopathological variables, including age, BMI, prostate-specific antigen (PSA), PSA density, DRE, Biopsy Gleason score, Positive biopsy cores, PIRADS v2.1 score, MRI volume and MRI lesion size were extracted. The sensitivity, specificity, and accuracy of MRI and PSMA PET/CT for predicting SVI were compared with the histopathological results by receiver operating characteristic (ROC) analysis. Subgroup univariate and multivariate analysis was performed. Results: Of the 528 patients identified, 86 had SVI on final pathology. MRI had a low sensitivity of 0.162 (95% CI: 0.088-0.261) and a high specificity of 0.963 (95% CI: 0.940-0.979). The PSMA PET/CT had a low sensitivity of 0.439 (95% CI: 0.294-0591) and a high specificity of 0.933 (95% CI: 0.849-0.969). When MRI and PSMA PET/CT were used in combination, the sensitivity and specificity improved to 0.514 (95%CI: 0.356-0.670) and 0.880 (95% CI: 0.813-0.931). The multivariate regression showed a higher biopsy Gleason score (p = 0.033), higher PSA (p < 0.001), older age (p = 0.001), and right base lesions (p = 0.003) to be predictors of SVI. Conclusions: MRI and PSMA PET/CT independently underpredicted SVI. The sensitivity and AUC improved when they were used in combination. Multiple clinicopathological factors were associated with SVI on multivariate regression and predictive models incorporating this information may improve oncological outcomes.
Collapse
Affiliation(s)
- Darshan Sitharthan
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Department of Urology, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia
| | - Song Kang
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Patrick-Julien Treacy
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Jacob Bird
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Kate Alexander
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Sascha Karunaratne
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Scott Leslie
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Department of Urology, Royal Prince Alfred Hospital (RPAH), Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Lewis Chan
- Department of Urology, Concord Repatriation General Hospital (CRGH), Sydney, NSW 2139, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
| | - Ruban Thanigasalam
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road, Sydney, NSW 2050, Australia
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW 2050, Australia
- Department of Urology, Concord Repatriation General Hospital (CRGH), Sydney, NSW 2139, Australia
| |
Collapse
|
2
|
Guerra A, Alves FC, Maes K, Joniau S, Cassis J, Maio R, Cravo M, Mouriño H. Early biomarkers of extracapsular extension of prostate cancer using MRI-derived semantic features. Cancer Imaging 2022; 22:74. [PMID: 36550525 PMCID: PMC9784252 DOI: 10.1186/s40644-022-00509-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To construct a model based on magnetic resonance imaging (MRI) features and histological and clinical variables for the prediction of pathology-detected extracapsular extension (pECE) in patients with prostate cancer (PCa). METHODS We performed a prospective 3 T MRI study comparing the clinical and MRI data on pECE obtained from patients treated using robotic-assisted radical prostatectomy (RARP) at our institution. The covariates under consideration were prostate-specific antigen (PSA) levels, the patient's age, prostate volume, and MRI interpretative features for predicting pECE based on the Prostate Imaging-Reporting and Data System (PI-RADS) version 2.0 (v2), as well as tumor capsular contact length (TCCL), length of the index lesion, and prostate biopsy Gleason score (GS). Univariable and multivariable logistic regression models were applied to explore the statistical associations and construct the model. We also recruited an additional set of participants-which included 59 patients from external institutions-to validate the model. RESULTS The study participants included 184 patients who had undergone RARP at our institution, 26% of whom were pECE+ (i.e., pECE positive). Significant predictors of pECE+ were TCCL, capsular disruption, measurable ECE on MRI, and a GS of ≥7(4 + 3) on a prostate biopsy. The strongest predictor of pECE+ is measurable ECE on MRI, and in its absence, a combination of TCCL and prostate biopsy GS was significantly effective for detecting the patient's risk of being pECE+. Our predictive model showed a satisfactory performance at distinguishing between patients with pECE+ and patients with pECE-, with an area under the ROC curve (AUC) of 0.90 (86.0-95.8%), high sensitivity (86%), and moderate specificity (70%). CONCLUSIONS Our predictive model, based on consistent MRI features (i.e., measurable ECE and TCCL) and a prostate biopsy GS, has satisfactory performance and sufficiently high sensitivity for predicting pECE+. Hence, the model could be a valuable tool for surgeons planning preoperative nerve sparing, as it would reduce positive surgical margins.
Collapse
Affiliation(s)
- Adalgisa Guerra
- grid.414429.e0000 0001 0163 5700Radiology Department, Hospital da Luz Lisboa, Avenida Lusíada, n° 100, 1500-650 Lisbon, Portugal
| | - Filipe Caseiro Alves
- grid.8051.c0000 0000 9511 4342Faculty of Medicine, Clinical Research CIBIT/ICNAS, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Kris Maes
- grid.414429.e0000 0001 0163 5700Urology Department, Hospital da Luz Lisboa, Avenida Lusíada, n° 100, 1500-650 Lisbon, Portugal
| | - Steven Joniau
- grid.410569.f0000 0004 0626 3338Urology Department, University Hospitals Leuven, UZ Leuven gasthuisberg campus, Urology, Herestraat 49, 3000 Leuven, Belgium
| | - João Cassis
- grid.414429.e0000 0001 0163 5700Pathology Department, Hospital da Luz Lisboa, Avenida Lusíada, n° 100, 1500-650 Lisbon, Portugal
| | - Rui Maio
- grid.10772.330000000121511713Nova Medical School-Nova University of Lisbon, Portugal e Hospital da Luz Lisboa, Campo Mártires da Pátria, n° 130, 1169-056 Lisbon, Portugal
| | - Marília Cravo
- grid.414429.e0000 0001 0163 5700Gastroenterology Department- Hospital da Luz Lisboa, Avenida Lusíada, n° 100, 1500-650 Lisbon, Portugal
| | - Helena Mouriño
- grid.9983.b0000 0001 2181 4263Centro de Estatística e Aplicações, Departamento de Estatística e Investigação Operacional, Faculdade de Ciências, Universidade de Lisboa, Edifício C6 – Piso 4, Campo Grande, 1749 – 016 Lisbon, Portugal
| |
Collapse
|
3
|
Razmaria AA, Schoder H, Morris MJ. Advances in Prostate Cancer Imaging. Urol Oncol 2022. [DOI: 10.1007/978-3-030-89891-5_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
4
|
Surasi DSS, Chapin B, Tang C, Ravizzini G, Bathala TK. Imaging and Management of Prostate Cancer. Semin Ultrasound CT MR 2020; 41:207-221. [PMID: 32446432 DOI: 10.1053/j.sult.2020.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Prostate cancer (PCa) is the most common noncutaneous malignancy in men and the second leading cause of cancer related death in the United States. Men with clinical suspicion of PCa undergo tissue sampling and based on features including the Gleason score, Prostate Specific antigen (PSA) levels and clinical tumor (T) stage, patients are risk stratified into 6 major groups based on National Comprehensive Cancer Network (NCCN) guidelines. This forms the basis for deciding imaging and management. Active surveillance is the preferred approach for less aggressive tumors. Surgery or radiation +/- androgen deprivation therapy continue to be the primary treatment options for localized disease. Imaging plays a critical role in the diagnosis, staging and management of PCa. Multiparametric magnetic resonance imaging (mpMRI) is currently the imaging modality of choice for locoregional staging. MRI, computed tomography and bone scan remain the preferred modalities for evaluation of nodal, soft tissue, and bone metastases, respectively. Advanced positron emission tomography imaging using novel radiotracers are being developed but are not yet integrated in the diagnostic guidelines for initial staging. In this review, we will discuss the imaging and treatment algorithms based on the NCCN risk groups, describe the utility of individual modalities, review Prosate Imaging and Reporting and Data System (PIRADS) version 2.1 for the reporting of mpMRI of the prostate.
Collapse
Affiliation(s)
- Devaki Shilpa Sudha Surasi
- Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Brian Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gregory Ravizzini
- Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tharakeswara Kumar Bathala
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
5
|
Trabulsi EJ, Rumble RB, Jadvar H, Hope T, Pomper M, Turkbey B, Rosenkrantz AB, Verma S, Margolis DJ, Froemming A, Oto A, Purysko A, Milowsky MI, Schlemmer HP, Eiber M, Morris MJ, Choyke PL, Padhani A, Oldan J, Fanti S, Jain S, Pinto PA, Keegan KA, Porter CR, Coleman JA, Bauman GS, Jani AB, Kamradt JM, Sholes W, Vargas HA. Optimum Imaging Strategies for Advanced Prostate Cancer: ASCO Guideline. J Clin Oncol 2020; 38:1963-1996. [PMID: 31940221 DOI: 10.1200/jco.19.02757] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Provide evidence- and expert-based recommendations for optimal use of imaging in advanced prostate cancer. Due to increases in research and utilization of novel imaging for advanced prostate cancer, this guideline is intended to outline techniques available and provide recommendations on appropriate use of imaging for specified patient subgroups. METHODS An Expert Panel was convened with members from ASCO and the Society of Abdominal Radiology, American College of Radiology, Society of Nuclear Medicine and Molecular Imaging, American Urological Association, American Society for Radiation Oncology, and Society of Urologic Oncology to conduct a systematic review of the literature and develop an evidence-based guideline on the optimal use of imaging for advanced prostate cancer. Representative index cases of various prostate cancer disease states are presented, including suspected high-risk disease, newly diagnosed treatment-naïve metastatic disease, suspected recurrent disease after local treatment, and progressive disease while undergoing systemic treatment. A systematic review of the literature from 2013 to August 2018 identified fully published English-language systematic reviews with or without meta-analyses, reports of rigorously conducted phase III randomized controlled trials that compared ≥ 2 imaging modalities, and noncomparative studies that reported on the efficacy of a single imaging modality. RESULTS A total of 35 studies met inclusion criteria and form the evidence base, including 17 systematic reviews with or without meta-analysis and 18 primary research articles. RECOMMENDATIONS One or more of these imaging modalities should be used for patients with advanced prostate cancer: conventional imaging (defined as computed tomography [CT], bone scan, and/or prostate magnetic resonance imaging [MRI]) and/or next-generation imaging (NGI), positron emission tomography [PET], PET/CT, PET/MRI, or whole-body MRI) according to the clinical scenario.
Collapse
Affiliation(s)
- Edouard J Trabulsi
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | | | | | - Thomas Hope
- University of California, San Francisco, San Francisco, CA
| | | | | | | | - Sadhna Verma
- University of Cincinnati Medical Center, Cincinnati, OH
| | | | | | | | | | | | | | | | | | | | - Anwar Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Jorge Oldan
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | - Suneil Jain
- Queen's University Belfast, Belfast, Northern Ireland
| | | | | | | | | | | | | | | | - Westley Sholes
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | | |
Collapse
|
6
|
Pomykala KL, Farolfi A, Hadaschik B, Fendler WP, Herrmann K. Molecular Imaging for Primary Staging of Prostate Cancer. Semin Nucl Med 2019; 49:271-279. [DOI: 10.1053/j.semnuclmed.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
7
|
Fanti S, Minozzi S, Antoch G, Banks I, Briganti A, Carrio I, Chiti A, Clarke N, Eiber M, De Bono J, Fizazi K, Gillessen S, Gledhill S, Haberkorn U, Herrmann K, Hicks RJ, Lecouvet F, Montironi R, Ost P, O'Sullivan JM, Padhani AR, Schalken JA, Scher HI, Tombal B, van Moorselaar RJA, Van Poppel H, Vargas HA, Walz J, Weber WA, Wester HJ, Oyen WJG. Consensus on molecular imaging and theranostics in prostate cancer. Lancet Oncol 2019; 19:e696-e708. [PMID: 30507436 DOI: 10.1016/s1470-2045(18)30604-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/09/2018] [Accepted: 08/09/2018] [Indexed: 10/27/2022]
Abstract
Rapid developments in imaging and treatment with radiopharmaceuticals targeting prostate cancer pose issues for the development of guidelines for their appropriate use. To tackle this problem, international experts representing medical oncologists, urologists, radiation oncologists, radiologists, and nuclear medicine specialists convened at the European Association of Nuclear Medicine Focus 1 meeting to deliver a balanced perspective on available data and clinical experience of imaging in prostate cancer, which had been supported by a systematic review of the literature and a modified Delphi process. Relevant conclusions included the following: diphosphonate bone scanning and contrast-enhanced CT are mentioned but rarely recommended for most patients in clinical guidelines; MRI (whole-body or multiparametric) and prostate cancer-targeted PET are frequently suggested, but the specific contexts in which these methods affect practice are not established; sodium fluoride-18 for PET-CT bone scanning is not widely advocated, whereas gallium-68 or fluorine-18 prostate-specific membrane antigen gain acceptance; and, palliative treatment with bone targeting radiopharmaceuticals (rhenium-186, samarium-153, or strontium-89) have largely been replaced by radium-223 on the basis of the survival benefit that was reported in prospective trials, and by other systemic therapies with proven survival benefits. Although the advances in MRI and PET-CT have improved the accuracy of imaging, the effects of these new methods on clinical outcomes remains to be established. Improved communication between imagers and clinicians and more multidisciplinary input in clinical trial design are essential to encourage imaging insights into clinical decision making.
Collapse
Affiliation(s)
- Stefano Fanti
- Nuclear Medicine Division, Policlinico S Orsola, University of Bologna, Bologna, Italy.
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Ian Banks
- European Cancer Organisation and European Men's Health Forum, Ulster, UK
| | - Alberto Briganti
- Division of Oncology and Unit of Urology, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy
| | - Ignasi Carrio
- Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Arturo Chiti
- Humanitas University and Humanitas Research Hospital, Milan, Italy
| | | | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Karim Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, Paris, France
| | - Silke Gillessen
- Division of Cancer Sciences, University of Manchester and The Christie Hospital, Manchester, UK; Division of Oncology and Division of Haematology, Kantonsspital St Gallen and University of Bern, Bern, Switzerland
| | | | - Uwe Haberkorn
- Department of Nuclear Medicine and German Cancer Research Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - Rodney J Hicks
- Cancer Imaging, Peter MacCallum Cancer Institute, Melbourne, VIC, Australia
| | - Frederic Lecouvet
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Rodolfo Montironi
- Genitourinary Cancer Program, Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region, Ancona, Italy
| | - Piet Ost
- Genitourinary Program, Ghent University Hospital, Ghent, Belgium
| | - Joe M O'Sullivan
- Department of Radiotherapy and Experimental Cancer Research, Queen's University, Belfast, UK
| | - Anwar R Padhani
- Mount Vernon Cancer Centre, Mount Vernon Hospital, London, UK
| | - Jack A Schalken
- Department of Experimental Urology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Howard I Scher
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Bertrand Tombal
- Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | | | - Heindrik Van Poppel
- Urology, University Hospital Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hebert Alberto Vargas
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France
| | - Wolfgang A Weber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hans-Jürgen Wester
- Lehrstuhl für Pharmazeutische Radiochemie, Technische Universität München, Garching, Germany
| | - Wim J G Oyen
- Department of Nuclear Medicine, Radboud University Medical Centre, Nijmegen, Netherlands; Department of Nuclear Medicine, The Institute of Cancer Research and The Royal Marsden National Health Service Foundation Trust, London, UK
| |
Collapse
|
8
|
Bai K, Sun Y, Li W, Zhang L. Apparent diffusion coefficient in extraprostatic extension of prostate cancer: a systematic review and diagnostic meta-analysis. Cancer Manag Res 2019; 11:3125-3137. [PMID: 31114355 PMCID: PMC6489658 DOI: 10.2147/cmar.s191738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/07/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) for local staging of prostate cancer. Methods: Databases of Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar were searched up to May 31, 2018, with language restricted to English. All studies concerning multiparametric magnet resonance imaging (mpMRI) with ADC for detection of extracapsular extension (ECE, T3a) and/or extraprostatic extension (EPE, overall stage of T3) were identified by two reviewers independently, and quality of included studies was evaluated using Quality Assessment of Diagnostic Accuracy Studies-2 tool. True positive, false positive, false negative and true negative of each study were extracted to reconstruct the 2×2 tables for evaluating diagnostic accuracy. Summary estimates of sensitivity, specificity, and corresponding 95% CIs were calculated with bivariate model and hierarchical summary receiver operating characteristic model, then presented in forest plots. Multiple subgroup analyses and meta-regression were performed, and publication bias was evaluated with Deeks funnel. Results: A total of 18 studies were included, with 6 involved ECE and 12 for EPE. Pooled sensitivity was 80.5% (95% CI 76.5-83.9%) with specificity of 69.1% (95% CI 62.3-75.2%). Multiple subgroup analyses showed that if ADC and length of capsular contact are regarded as independent predictors, pooled sensitivity was 85% (95% CI 77-90%) and 81.1% (95% CI 76.0-85.3%), with specificity of 70.8% (95% CI 56.3-82.0%) and 66.6% (95% CI 57.6-74.5%), respectively. Meta-regression demonstrated that there was no substantially significant difference in types of coil, magnet field strength (1.5T versus 3.0T), and analysis method (per-lesion versus per-patient). Conclusion: By introducing ADC to MRI, we could obtain favorable sensitivity for diagnostic performance of EPE, but with a little decreased specificity.
Collapse
Affiliation(s)
- Koudi Bai
- Department of Radiology, Yancheng First Peoples’ Hospital, Yancheng City, People’s Republic of China
| | - Yuan Sun
- Department of Orthopedics, No.97 Hospital of People’s Liberation Army of China, Xuzhou City, People’s Republic of China
| | - Wei Li
- Department of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng City, People’s Republic of China
| | - Lanlan Zhang
- Department of Pediatrics, Yancheng Maternal and Child Health Hospital, Yancheng City, People’s Republic of China
| |
Collapse
|
9
|
Schiavina R, Chessa F, Borghesi M, Gaudiano C, Bianchi L, Corcioni B, Castellucci P, Ceci F, Ceravolo I, Barchetti G, Del Monte M, Campa R, Catalano C, Panebianco V, Nanni C, Fanti S, Minervini A, Porreca A, Brunocilla E. State-of-the-art imaging techniques in the management of preoperative staging and re-staging of prostate cancer. Int J Urol 2018; 26:18-30. [DOI: 10.1111/iju.13797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/18/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Riccardo Schiavina
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Francesco Chessa
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Marco Borghesi
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Caterina Gaudiano
- Radiology Unit; Department of Diagnostic Medicine and Prevention; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Lorenzo Bianchi
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Beniamino Corcioni
- Radiology Unit; Department of Diagnostic Medicine and Prevention; St. Orsola-Malpighi Hospital; Bologna Italy
| | - Paolo Castellucci
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Francesco Ceci
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
- Ahmanson Translational Imaging Division; Department of Molecular and Medical Pharmacology; University of California at Los Angeles; Los Angeles California USA
| | - Isabella Ceravolo
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Giovanni Barchetti
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Maurizio Del Monte
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Riccardo Campa
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Carlo Catalano
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Valeria Panebianco
- Prostate Unit-Department of Radiological Sciences, Oncology and Pathology; Sapienza University of Rome; Rome Italy
| | - Cristina Nanni
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Stefano Fanti
- Metropolitan Nuclear Medicine; St. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - Andrea Minervini
- Department of Urology; Careggi Hospital; University of Florence; Florence Italy
| | - Angelo Porreca
- Department of Robotic Urological Surgery; Abano Terme Hospital; Abano Terme Italy
| | - Eugenio Brunocilla
- Department of Urology; University of Bologna; St. Orsola-Malpighi Hospital; Bologna Italy
| |
Collapse
|
10
|
de Rooij M, Hamoen EH, Witjes JA, Barentsz JO, Rovers MM. Accuracy of Magnetic Resonance Imaging for Local Staging of Prostate Cancer: A Diagnostic Meta-analysis. Eur Urol 2016. [DOI: 10.1016/j.eururo.2015.07.029] [Citation(s) in RCA: 366] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
11
|
Davis R, Salmasi A, Koprowski C, Kim S, Kwon YS, Faiena I, Patel N, Elsamra SE, Kim IY. Accuracy of Multiparametric Magnetic Resonance Imaging for Extracapsular Extension of Prostate Cancer in Community Practice. Clin Genitourin Cancer 2016; 14:e617-e622. [PMID: 27188968 DOI: 10.1016/j.clgc.2016.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 04/13/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The presence of extracapsular extension (ECE) in prostate cancer (PCa) can influence a surgeon's decision to perform a nerve-sparing approach during radical prostatectomy (RP). Preoperatively, multiparametric MRI (mp-MRI) is often used to stage PCa. More recently, the use of mp-MRI has gained wide acceptance in fusion biopsy of the prostate. In this framework, the reported accuracy of mp-MRI has been highly variable, with data often originating from large referral centers with experienced radiologists. We sought to determine the sensitivity and specificity of mp-MRI for detecting ECE in the community. MATERIALS AND METHODS We reviewed a prospectively maintained database of men with PCa who had undergone RP. We recorded the prevalence of ECE at RP and determined the sensitivity, specificity, positive predictive value, and negative predictive value of MRI for detecting ECE. We assessed these values according to the D'Amico risk groups and compared the predictive value of MRI to that of the Partin tables. RESULTS The prevalence of ECE was 11.5%, 28.1%, and 47.1% in the low-, intermediate, and high-risk groups, respectively, with an overall prevalence of 24.1%. The overall sensitivity, specificity, positive predictive value, and negative predictive value of MRI was 12.5%, 93.1%, 36.4%, and 77.0%, respectively. CONCLUSION The reduction in the sensitivity of preoperative mp-MRI to determine ECE in the community setting is significant. Even with stratification using the D'Amico criteria and Partin tables, the performance of mp-MRI was not significantly improved. Because most cases of PCa are diagnosed and treated in the community, it is questionable whether mp-MRI is a suitable staging modality in the community.
Collapse
Affiliation(s)
- Rachel Davis
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Amirali Salmasi
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Christopher Koprowski
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Sinae Kim
- Department of Biostatistics, Rutgers School of Public Health, Piscataway, NJ
| | - Young Suk Kwon
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Izak Faiena
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Neal Patel
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Sammy E Elsamra
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Isaac Yi Kim
- Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey and Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
| |
Collapse
|
12
|
Sharma P, Marangmei C. Seminal vesicle metastasis from carcinoma lung: A very unusual metastatic site detected with (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med 2015; 30:368. [PMID: 26430332 PMCID: PMC4579633 DOI: 10.4103/0972-3919.159696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Punit Sharma
- Department of Nuclear Medicine and PET/CT, Eastern Diagnostics Ltd., Kolkata, West Bengal, India
| | - Chung Marangmei
- Department of Nuclear Medicine and PET/CT, Eastern Diagnostics Ltd., Kolkata, West Bengal, India
| |
Collapse
|
13
|
Wibmer AG, Vargas HA, Hricak H. Role of MRI in the diagnosis and management of prostate cancer. Future Oncol 2015; 11:2757-66. [PMID: 26367323 DOI: 10.2217/fon.15.206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Multiparametric MRI of the prostate consists of T1- and T2-weighted sequences, which provide anatomical information, and one or more 'functional' sequences, that is, diffusion-weighted imaging, dynamic contrast-enhanced sequences and magnetic resonance spectroscopy. Prostate MRI is the most accurate imaging method for local staging of prostate cancer and can also be used for the noninvasive evaluation of tumor aggressiveness. By magnetic resonance-guided prostate biopsy it is possible to target the most cancer-suspicious areas of the gland, especially in patients with a negative transrectal biopsy. In patients with biochemical recurrence after radical treatment, MRI is a valuable tool for the detection of local tumor recurrence and whole-body MRI can be used for the diagnosis of distant metastases.
Collapse
Affiliation(s)
- Andreas G Wibmer
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
| | - Hebert Alberto Vargas
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
| | - Hedvig Hricak
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York City, NY 10065, USA
| |
Collapse
|
14
|
Multiparametric MRI for localized prostate cancer: lesion detection and staging. BIOMED RESEARCH INTERNATIONAL 2014; 2014:684127. [PMID: 25525600 PMCID: PMC4266765 DOI: 10.1155/2014/684127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 09/28/2014] [Accepted: 10/03/2014] [Indexed: 11/18/2022]
Abstract
Multiparametric MRI of the prostate combines high-resolution anatomic imaging with functional imaging of alterations in normal tissue caused by neoplastic transformation for the identification and characterization of in situ prostate cancer. Lesion detection relies on a systematic approach to the analysis of both anatomic and functional imaging using established criteria for the delineation of suspicious areas. Staging includes visual and functional analysis of the prostate "capsule" to determine if in situ disease is, in fact, organ-confined, as well as the evaluation of pelvic structures including lymph nodes and bones for the detection of metastasis. Although intertwined, the protocol can be optimized depending on whether lesion detection or staging is of the highest priority.
Collapse
|
15
|
The accuracy of magnetic resonance imaging in prostate cancer staging: a single-institution experience. Ir J Med Sci 2014; 184:313-7. [DOI: 10.1007/s11845-014-1109-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 03/19/2014] [Indexed: 12/16/2022]
|