Combined Clinical Parameters and Multiparametric Magnetic Resonance Imaging for the Prediction of Extraprostatic Disease—A Risk Model for Patient-tailored Risk Stratification When Planning Radical Prostatectomy

Nyarangi‐Dix, Joanne; Wiesenfarth, Manuel; Bonekamp, David; Hitthaler, Bertram; Schütz, Viktoria; Dieffenbacher, Svenja; Mueller-Wolf, Maya; Roth, Wilfried; Duensing, Stefan; Roethke, Matthias; Teber, Doğu; Hohenfellner, Markus; Radtke, Jan Philipp

doi:10.1016/j.euf.2018.11.004

Cited by 50 publications

(42 citation statements)

References 32 publications

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“…Nomograms combining clinicopathological information including prostate-specific antigen (PSA) levels, clinical stage based on digital rectal examination, and biopsyrelated information (Gleason score, number, and percentage of positive cores) are often used to predict the extent of prostate cancer (Ohori et al 2004). However, there is an increasing number of studies showing that incorporating preoperative magnetic resonance imaging (MRI) results provide incremental value in predicting SVI and EPE (Ohori et al 2004;Nyarangi-Dix et al 2018;Mehralivand et al 2019;Park et al 2020). Nevertheless, these results are still imperfect with area under the curves (AUC) ranging from 0.74-0.87 (Jansen et al 2019;Wang et al 2007;Weaver et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis

Woo

Ghafoor

Becker

et al. 2020

European J Hybrid Imaging

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Purpose Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown promise for detecting nodal and distant prostate cancer (PCa) metastases. However, its performance for local tumor staging is not as well established. The purpose of this study was to review the diagnostic performance of PSMA-PET for determining seminal vesical invasion (SVI) and extraprostatic extension (EPE). Methods Pubmed and Embase databases were searched until January 12, 2020. Studies assessing accuracy of PSMA-PET in determining SVI and EPE were included. Study quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity were calculated using hierarchical summary receiver operating characteristics modeling. Heterogeneity was explored using meta-regression analyses for anatomical imaging component (MRI vs CT) and by testing for a threshold effect. Results Twelve studies (615 patients) were included. Pooled sensitivity and specificity were 0.68 (95% CI 0.53-0.81) and 0.94 (95% CI 0.90-0.96) for SVI and 0.72 (95% CI 0.56-0.84) and 0.87 (95% CI 0.72-0.94) for EPE. Meta-regression analyses showed that for SVI, PET/MRI demonstrated greater sensitivity than PET/CT (0.87 [95% CI 0.75-0.98] vs 0.60 [95% CI 0.47-0.74]; p = 0.02 for joint model) while specificity was comparable (0.91 [95% CI 0.84-0.97] vs. 0.96 [95% CI 0.93-0.99]) but not for EPE (p = 0.08). A threshold effect was present for studies assessing EPE (correlation coefficient = 0.563 [95% CI, −0.234-0.908] between sensitivity and false-positive rate). Conclusion PSMA-PET has moderate sensitivity and excellent specificity for assessing local tumor extent in patients with PCa. PET/MRI showed potential for greater sensitivity than PET/CT in assessing SVI.

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Section: Introductionmentioning

confidence: 99%

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis

Woo

Ghafoor

Becker

et al. 2020

European J Hybrid Imaging

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“…For this reason, all the tools able to provide details on EPE before treatment may be of help in evaluating benefits and harms of nerve-sparing techniques and in tailoring treatment strategies in function of patient's characteristics (64).…”

Section: Multiparametric Mri When Planning Radical Prostatectomymentioning

confidence: 99%

Multiparametric MRI in the management of prostate cancer: an update—a narrative review

et al. 2020

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The growing interest in multiparametric MRI is leading to important changes in the diagnostic process of prostate cancer. MRI-targeted biopsy is likely to become a standard for the diagnosis of prostate cancer in the next years. Despite it is well known that MRI has no role as a staging technique, it is clear that multiparametric MRI may be of help in active surveillance protocols. Noteworthy, MRI in active surveillance is not recommended, but a proper understanding of its potential may be of help in achieving the goals of a delayed treatment strategy. Moreover, the development of minimally invasive techniques, like laparoscopic and robotic surgery, has led to greater expectations as regard to the functional outcomes of radical prostatectomy. Multiparametric MRI may play a role in planning surgical strategies, with the aim to provide the highest oncologic outcome with a minimal impact on the quality of life. We maintain that a proper anatomic knowledge of prostate lesions may allow the surgeon to achieve a better result in planning as well as in performing surgery and help the surgeon and the patient engage in a shared decision in planning a more effective strategy for prostate cancer control and treatment. This review highlights the advantages and the limitations of multiparametric MRI in prostate cancer diagnosis, in active surveillance and in planning surgery.

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“…Nomograms combining clinicopathological information including prostate-specific antigen (PSA) levels, clinical stage based on digital rectal examination, and biopsy-related information (Gleason score, number and percentage of positive cores) are often used to predict the extent of prostate cancer [4]. However, there is an increasing number of studies showing that incorporating preoperative magnetic resonance imaging (MRI) results provide incremental value in predicting SVI and EPE [4][5][6][7]. Nevertheless, these results are still imperfect with area under the curves (AUC) ranging from 0.74-0.87 [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of Prostate Cancer: A Systematic Review and Meta-Analysis

Woo

Ghafoor

Becker

et al. 2020

Preprint

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Purpose: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown promise for detecting nodal and distant prostate cancer (PCa) metastases. However, its performance for local tumor staging is not as well established. The purpose of this study was to review the diagnostic performance of PSMA-PET for determining seminal vesical invasion (SVI) and extraprostatic extension (EPE).Methods: Pubmed and Embase databases were searched until January 12, 2020. Studies assessing accuracy of PSMA-PET in determining SVI and EPE were included. Study quality was evaluated with the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity were calculated using hierarchical summary receiver operating characteristics modeling. Heterogeneity was explored using meta-regression analyses for anatomical imaging component (MRI vs CT) and by testing for a threshold effect.Results: 12 studies (615 patients) were included. Pooled sensitivity and specificity were 0.68 (95%CI 0.53-0.81) and 0.94 (95% CI 0.90-0.96) for SVI and 0.72 (95% CI 0.56-0.84) and 0.87 (95%CI 0.72-0.94) for EPE. Meta-regression analyses showed that for SVI, PET/MRI demonstrated greater sensitivity than PET/CT (0.87 [95%CI 0.75-0.98] vs 0.60 [95% CI 0.47-0.74]; p = 0.02 for joint model) while specificity was comparable (0.91 [95%CI 0.84-0.97] vs. 0.96 [95%CI 0.93-0.99]) but not for EPE (p = 0.08). A threshold effect was present for studies assessing EPE (correlation coefficient = 0.563 [95% CI, -0.234-0.908] between sensitivity and false-positive rate).Conclusion: PSMA-PET has moderate sensitivity and excellent specificity for assessing local tumor extent in patients with PCa. PET/MRI shows significantly greater sensitivity than PET/CT for assessing SVI.

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Combined Clinical Parameters and Multiparametric Magnetic Resonance Imaging for the Prediction of Extraprostatic Disease—A Risk Model for Patient-tailored Risk Stratification When Planning Radical Prostatectomy

Cited by 50 publications

References 32 publications

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis

Multiparametric MRI in the management of prostate cancer: an update—a narrative review

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of Prostate Cancer: A Systematic Review and Meta-Analysis

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