Added Value of Multiparametric Magnetic Resonance Imaging to Clinical Nomograms for Predicting Adverse Pathology in Prostate Cancer

Rayn, Kareem; Bloom, Jonathan; Gold, Samuel; Hale, Graham; Baiocco, Joseph A.; Mehralivand, Sherif; Czarniecki, Marcin; Sabarwal, Vikram; Valera, Vladimir; Wood, Bradford J.; Merino, María J.; Choyke, Peter L.; Türkbey, Barış; Pinto, Peter A.

doi:10.1016/j.juro.2018.05.094

Cited by 72 publications

(64 citation statements)

References 25 publications

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“…Regardless of the radiologist experience, the combination of clinical models and mpMRI provided significantly robust tools in terms of discriminatory power, and increased the AUCs compared with clinical models alone. This is in line with previous results on EPE by Morlacco et al using PT (AUC from 0.61 to 0.73) and CAPRA (AUC from 0.69 to 0.77), Feng et al using PT (AUC from 0.85 to 0.93) and MSKCCn (AUC from 0.86 to 0.94), as well as Ryan et al using MSKCCn (AUC from 0.70 to 0.80) and PT (AUC from 0.66 to 0.80) in a subpopulation of patients undergoing systematic biopsy without image fusion. In contrast, Weaver et al found no incremental value of mpMRI compared with MSKCCn.…”

Section: Discussionsupporting

confidence: 92%

“…However, they match with those found by Morlacco et al on a population with more advanced disease at diagnosis (Gleason score 8 or larger and high risk at the D'Amico classification in 44% and 55.8% of cases, respectively), thus indirectly suggesting that mpMRI can be effectively added to clinical models in different clinical populations. Of note, we found a prevalence of pathology‐proven EPE of 32.9%, ie, within the range of previous studies (21.6–42.3%) …”

Section: Discussionsupporting

confidence: 90%

“…There is some debate as to whether an increased risk for EPE, or increased rate of EPE at final pathology, can overestimate the effect of adding mpMRI to clinical models . Our results were obtained on a cohort of patients showing low risk of EPE, as testified by the results of clinical models.…”

Section: Discussionmentioning

confidence: 93%

“…Over the last years, multiparametric magnetic resonance imaging (mpMRI) has gained acceptance as a tool to stage high‐risk PCa and intermediate‐risk PCa with predominantly Gleason pattern 4 . However, there are not yet definite indications on the use of pretreatment mpMRI, given the still limited availability, the need for expertise in performing and reading the examination, as well as increased costs in the high‐prevalence setting of PCa …”

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confidence: 99%

“…mpMRI shows some advantages over clinical models, including information on the location and anatomical extent of disease, and has the potential of shifting PCa stage and risk category as initially defined on a clinical basis . Several previous works showed that adding mpMRI to PT, MSKCCn, or the CAPRA score improves the prediction of EPE and/or SVI at final pathology . Other investigators found that mpMRI outperforms PT in predicting organ‐confined disease, thus having the potential of acting as a stand‐alone staging tool.…”

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confidence: 99%

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Head‐to‐head comparison between multiparametric MRI, the partin tables, memorial sloan kettering cancer center nomogram, and CAPRA score in predicting extraprostatic cancer in patients undergoing radical prostatectomy

Zanelli

Giannarini

Cereser

et al. 2019

Magnetic Resonance Imaging

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Background It is unclear whether clinical models including the Partin tables (PT), the Memorial Sloan Kettering Cancer Center nomogram (MSKCCn), and the cancer of the prostate risk assessment (CAPRA) can benefit from incorporating multiparametric magnetic resonance imaging (mpMRI) when staging prostate cancer (PCa). Purpose To compare the accuracy of clinical models, mpMRI, and mpMRI plus clinical models in predicting stage ≥pT3 of PCa. Study Type Prospective monocentric cohort study. Population Seventy‐three patients who underwent radical prostatectomy between 2016–2018. Field Strength/Sequence 3.0T using turbo spin echo (TSE) imaging, single‐shot echoplanar diffusion‐weighted imaging, and T1‐weighted high‐resolution‐isotropic‐volume‐examination (THRIVE) contrast‐enhanced imaging. Assessment We calculated the probability of extraprostatic extension (EPE) using the PT and MSKCC, as well as the CAPRA score. Three readers with 2–8 years of experience in mpMRI independently staged PCa on imaging. Statistical Tests Receiver operating characteristics analysis and logistic regression analysis to investigate the per‐patient accuracy of mpMRI vs. clinical models vs. mpMRI plus clinical models in predicting stage ≥pT3. The alpha level was 0.05. Results Median probability for EPE and MSKCCn was 27.3% and 47.0%, respectively. Median CAPRA score was 3. Stage ≥pT3 occurred in 32.9% of patients. Areas under the curve (AUCs) were 0.62 for PT, 0.62 for MSKCCn, 0.64 for CAPRA, and 0.73–0.75 for mpMRI (readers 1–3) (P > 0.05 for all comparisons). Compared with mpMRI, the combination of mpMRI with PT or MSKCCn provided lower AUCs (P > 0.05 for all the readers), while the combination with CAPRA provided significantly higher (P < 0.05) AUCs in the case of readers 1 and 3. On multivariable analysis, mpMRI by reader 1 was the only independent predictor of stage ≥pT3 (odds ratio 7.40). Data Conclusion mpMRI was more accurate than clinical models and mpMRI plus clinical models in predicting stage ≥pT3, except for the combination of mpMRI and CAPRA in two out of three readers. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1604–1613.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Head‐to‐head comparison between multiparametric MRI, the partin tables, memorial sloan kettering cancer center nomogram, and CAPRA score in predicting extraprostatic cancer in patients undergoing radical prostatectomy

Zanelli

Giannarini

Cereser

et al. 2019

Magnetic Resonance Imaging

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Impact of prebiopsy MRI on prostate cancer staging: Results from the Norwegian Prostate Cancer Registry

et al. 2023

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Objectives: The aim of this study is to evaluate the 2015 introduction of prebiopsy magnetic resonance imaging of the prostate (MRI-P) as the standard of care for diagnosing prostate cancer (PCa) by the Norwegian public health care authorities.There were three specific objectives of this study: first, to evaluate the consequences of using different TNM manuals for clinical T-staging (cT-staging) in a national setting; second, to determine if the data reveals that MRI-P based cT-staging is superior to digital rectal examination (DRE)-based cT-staging compared with pathological Tstage (pT-stage) post radical prostatectomy; and third, to assess whether treatment allocations have changed over time. Materials and Methods: All patients registered in the Norwegian Prostate Cancer Registry between 2004 and 2021 were retrieved and 5538 were eligible for inclusion. Concordance between clinical T-stage (cT-stage) and pT-stage was assessed by percentage agreement, Cohen's kappa and Gwet's agreement. Results: MR visualisation of lesions influences reporting of tumour extension beyond DRE findings. Agreement between cT-stage and pT-stage declined from 2004 to 2009, which coincided with an increase in the percentage being pT3. From 2010, agreement increased, which aligned with changes in cT-staging and the introduction of MRI-P. From 2017, regarding the reporting of cT-DRE and cT-Total (overall cT-stage), agreement diminished for cT-DRE but remained relatively stable (>60%) for cT-Total. Regarding treatment allocation, the study suggests that staging with MRI-P has shifted treatment towards radiotherapy in locally advanced high-risk disease. Conclusion: Introduction of MRI-P has affected cT-stage reporting. Agreement between cT-stage and pT-stage appears to have improved. This study suggests that use of MRI-P influences treatment decisions in certain patient subgroups.

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Transperineal Ultrasound Before and After Prostatectomy: Technical Approach and Description

Colarieti

Shaida

Thiruchelvam

et al. 2022

J of Ultrasound Medicine

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This study assessed the feasibility of dynamic transperineal ultrasound (TPUS) pre/post-radical prostatectomy (RP). Ninety-eight patients were scanned preoperatively and at four time-points post-operatively. TPUS was performed in 98 patients using an abdominal transducer at rest, during pelvic floor contraction (PFC) and Valsalva (VS) maneuver in supine and standing positions. Urodynamic evaluations included bladder neck angle at rest/PFC/VS, and degree of bladder neck movement. Pre-operative and post-operative measurements were technically feasible in >85% (supine) and >90% (standing) of patients. TPUS offers a reliable non-invasive dynamic assessment of the pelvic floor post-prostatectomy and may prove a useful adjunct for guiding exercises to preserve continence.

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Added Value of Multiparametric Magnetic Resonance Imaging to Clinical Nomograms for Predicting Adverse Pathology in Prostate Cancer

Cited by 72 publications

References 25 publications

Head‐to‐head comparison between multiparametric MRI, the partin tables, memorial sloan kettering cancer center nomogram, and CAPRA score in predicting extraprostatic cancer in patients undergoing radical prostatectomy

Head‐to‐head comparison between multiparametric MRI, the partin tables, memorial sloan kettering cancer center nomogram, and CAPRA score in predicting extraprostatic cancer in patients undergoing radical prostatectomy

Impact of prebiopsy MRI on prostate cancer staging: Results from the Norwegian Prostate Cancer Registry

Transperineal Ultrasound Before and After Prostatectomy: Technical Approach and Description

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