2019
DOI: 10.1007/s00330-019-06070-6
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Defining the incremental value of 3D T2-weighted imaging in the assessment of prostate cancer extracapsular extension

Abstract: Objectives To assess the added value of 3D T2-weighted imaging (T2WI) over conventional 2D T2WI in diagnosing extracapsular extension (ECE). Methods Seventy-five patients undergoing 3-T MRI before radical prostatectomy were included. PI-RADS ≥ 4 lesions were assessed for ECE on 2D T2W images using a 5-point Likert scale (1 = no ECE, 5 = definite ECE) and the length of tumour prostatic capsular contact. A second read using 3D T2W images and reformats evaluated ECE and th… Show more

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Cited by 35 publications
(37 citation statements)
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“…In the present study, prevalence of high Gleason tumors was a factor affecting heterogeneity, but no significant differences were observed in either sensitivity or specificity estimates. Nevertheless, in one of the included studies that additionally evaluated LCC stratified by tumor grade, mean LCC was significantly larger for higher grade tumors (15.3 mm vs. 9.0 mm, p = 0.0001) (25). Furthermore, for the LCC criterion of < 10 mm, 41.6% of higher-grade tumors still had EPE compared with only 2.8% of lower grade tumors (25).…”
Section: Discussionmentioning
confidence: 98%
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“…In the present study, prevalence of high Gleason tumors was a factor affecting heterogeneity, but no significant differences were observed in either sensitivity or specificity estimates. Nevertheless, in one of the included studies that additionally evaluated LCC stratified by tumor grade, mean LCC was significantly larger for higher grade tumors (15.3 mm vs. 9.0 mm, p = 0.0001) (25). Furthermore, for the LCC criterion of < 10 mm, 41.6% of higher-grade tumors still had EPE compared with only 2.8% of lower grade tumors (25).…”
Section: Discussionmentioning
confidence: 98%
“…Nevertheless, in one of the included studies that additionally evaluated LCC stratified by tumor grade, mean LCC was significantly larger for higher grade tumors (15.3 mm vs. 9.0 mm, p = 0.0001) (25). Furthermore, for the LCC criterion of < 10 mm, 41.6% of higher-grade tumors still had EPE compared with only 2.8% of lower grade tumors (25). Bakir et al (37) recently stated pathology-based LCC cutoff values decreased as the International Society of Urological Pathology grade group increased in terms of EPE positivity, substantiating the possible influence of tumor grade on the LCC-EPE relationship.…”
Section: Discussionmentioning
confidence: 99%
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“…In addition, the length of tumour contact with the capsule at MRI (Figure 3) has also been shown to be a strong predictor of ECE35,42,43 with good to excellent inter-reader agreement26, 35, (Figure 3). 26,35 However, a reliable threshold is yet to be established, with reported rates varying from 6–20 mm, the PI-RADS v2 guidelines recommend an arbitrary threshold of 10 mm19, which pre-dates many of these studies. The reason for variability is likely multifactorial with different methodology employed and variations in scanner strength, vendor and protocols.…”
Section: T-stagingmentioning
confidence: 93%
“…Fast-spin-echo (FSE) or turbo-spin-echo (TSE) imaging should be obtained in the axial plane and in least one additional orthogonal plane (sagittal or coronal) with the highest quality possible and thin slices at 3 mm with no gap 25. 3D T2 weighted imaging with isotropic voxels and slice thickness at 1 mm may be obtained, with evidence suggesting utility for assessment of extraprostatic extension26 and for nodal and bone staging when combined with DWI of the entire pelvis (b-values 0–1000 s/mm2). 27…”
Section: Mr Imagingmentioning
confidence: 99%