Detection of extracapsular extension of prostate carcinoma with endorectal and phased-array coil MR imaging: multivariate feature analysis.

Yu, Kyle K.; Hricak, Hedvig; Alagappan, R; Chernoff, Daniel M.; Bacchetti, Peter; Zaloudek, Charles

doi:10.1148/radiology.202.3.9051019

Cited by 268 publications

(151 citation statements)

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“…It was found that tumor volume per lobe estimated by MRSI was significantly (P Ͻ 0.01) higher in patients with ECE (2.14 Ϯ 2.3 cm 3 ) than in patients without ECE (0.98 Ϯ 1.1 cm 3 ) (29). Moreover the addition of an MRSI estimate of tumor volume to high-specificity MRI findings for ECE (74) improved the diagnostic accuracy and decreased the inter-observer variability of MRI in the diagnosis of extracapsular extension of prostate cancer (Fig. 2) (29).…”

Section: Improved Prostate Cancer Staging Using Combined Mri/mrsimentioning

confidence: 94%

“…However, the assessment of cancer spread through the prostatic capsule is more difficult (81% accuracy) (26) and is becoming even harder to assess as fewer men demonstrate gross cancer spread (directly visible on MRI) due to earlier cancer detection. In a recent study of 53 patients with earlystage prostate cancer, tumor volume estimates based on MRSI findings were combined with high-specificity MRI criteria (74) in order to assess the ability of combined MRI/MRSI to predict extracapsular cancer spread. This study was based on prior histopathologic studies that demonstrated that tumor volume was a significant predictor of extracapsular extension (ECE) of prostate cancer (75,76).…”

Section: Improved Prostate Cancer Staging Using Combined Mri/mrsimentioning

confidence: 99%

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Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

Kurhanewicz

Swanson

Nelson

et al. 2002

Magnetic Resonance Imaging

333

266

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Magnetic resonance spectroscopic imaging (MRSI) provides a noninvasive method of detecting small molecular markers (historically the metabolites choline and citrate) within the cytosol and extracellular spaces of the prostate, and is performed in conjunction with high-resolution anatomic imaging. Recent studies in pre-prostatectomy patients have indicated that the metabolic information provided by MRSI combined with the anatomical information provided by MRI can significantly improve the assessment of cancer location and extent within the prostate, extracapsular spread, and cancer aggressiveness. Additionally, pre-and post-therapy studies have demonstrated the potential of MRI/MRSI to provide a direct measure of the presence and spatial extent of prostate cancer after therapy, a measure of the time course of response, and information concerning the mechanism of therapeutic response. In addition to detecting metabolic biomarkers of disease behavior and therapeutic response, MRI/MRSI guidance can improve tissue selection for ex vivo analysis. High-resolution magic angle spinning ( 1 H HR-MAS) spectroscopy provides a full chemical analysis of MRI/MRSI-targeted tissues prior to pathologic and immunohistochemical analyses of the same tissue. Preliminary 1 H HR-MAS spectroscopy studies have already identified unique spectral patterns for healthy glandular and stromal tissues and prostate cancer, determined the composition of the composite in vivo choline peak, and identified the polyamine spermine as a new metabolic marker of prostate cancer. The addition of imaging sequences that provide other functional information within the same exam (dynamic contrast uptake imaging and diffusion-weighted imaging) have also demonstrated the potential to further increase the accuracy of prostate cancer detection and characterization.

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Section: Improved Prostate Cancer Staging Using Combined Mri/mrsimentioning

confidence: 94%

Section: Improved Prostate Cancer Staging Using Combined Mri/mrsimentioning

confidence: 99%

Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

Kurhanewicz

Swanson

Nelson

et al. 2002

Magnetic Resonance Imaging

333

266

View full text Add to dashboard Cite

show abstract

“…Subtle signs of EPE used in standardised reporting systems include: extent of contact of the tumour with the capsule, loss of the recto-prostatic angle, bulging or irregularity of the 'pseudo-capsule' , reduced signal in the peri-prostatic fat and asymmetry of the neurovascular bundle; these signs can increase the accuracy of MRI in detecting EPE to 77%-80% [110,111]. The main limitation of MRI in T-staging is limited sensitivity, due to its inability to detect microscopic EPE.…”

Section: Mri In T-staging Treatment Selection and Planningmentioning

confidence: 99%

The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

et al. 2013

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Background• The diagnosis of prostate cancer has long been plagued by the absence of an imaging tool that reliably detects and localises significant tumours. Recent evidence suggests that multi-parametric MRI could improve the accuracy of diagnostic assessment in prostate cancer. This review serves as a background to a recent USANZ position statement. It aims to provide an overview of MRI techniques and to critically review the published literature on the clinical application of MRI in prostate cancer. Technical Aspects• The combination of anatomical (T2-weighted) MRI with at least two of the three functional MRI parameterswhich include diffusion-weighted imaging, dynamic contrast-enhanced imaging and spectroscopy -will detect greater than 90% of significant (moderate to high risk) tumours; however MRI is less reliable at detecting tumours that are small (<0.5 cc), low grade (Gleason score 6) or in the transitional zone. The higher anatomical resolution provided by 3-Tesla magnets and endorectal coils may improve the accuracy, particularly in primary tumour staging.

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“…The reasons for this are likely multifactorial: patient selection, different protocols, differences in criteria used for interpretation and subspecialty experience of the radiologist. 6 Yu et al 30 in a study of 77 patients who had stage pT2 (the tumor is confined within the prostate gland) or pT3 (the tumor has extended through the prostatic capsule and/or to the seminal vesicles, but no other organs are affected) PCa and whose MR images were retrospectively reviewed by three readers with varying experience in interpretation of endorectal coil images of the prostate gland showed that reader's experience have an important role. The reader with the most experience achieved the best results for sensitivity, specificity and accuracy, and the interpretations showed a statistically significantly greater area under the receiver operating characteristic curve than those of the less experienced readers.…”

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confidence: 99%

Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate

Engelhard

Zugor

et al. 2009

Prostate Cancer Prostatic Dis

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The purpose of this study is to report our method in detecting prostate cancer (PCa) using an 18-core transrectal ultrasound (TRUS) prostate biopsy (PB) schema, in combination with additional targeted cores from suspicious images in conventional (e-cMRI) and functional (e-fMRI) endorectal magnetic resonance imaging (e-MRI) of the prostate. From 2004 to 2008, 260 consecutive patients with a clinical suspicion of PCa underwent PB and were prospectively studied. e-cMRI and e-fMRI was performed in all patients before PB. The patients were divided into two groups (A and B) according to the results of their radiological findings (group A ¼ suspicious findings, group B ¼ non-suspicious findings). After the images were processed, an 18-core TRUS-guided PB was performed. When a patient exhibited a suspicious site on e-cMRI and e-fMRI images, three additional targeted PBs were obtained from that site. In group A, 17.5% of PCa was detected by the 18-core PB and 56.5% of PCa was detected by the targeted cores. The overall PCa detection rate (18 þ targeted cores) was 73.9%. The overall specificity was 73.9%. In group B, overall false-positive detection rate reached 19.2%, with the overall sensitivity being 80.8%. The method described above is not only practical but also a promising modality in PCa detection. As seen, PCa was optimally detected when combining the 18-core and targeted-core PB schema together. Non-suspicious images do not rule out the probability of PCa, thus justifying a PB in these patients as well.

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Detection of extracapsular extension of prostate carcinoma with endorectal and phased-array coil MR imaging: multivariate feature analysis.

Abstract: Obliteration of the rectoprostatic angle and asymmetry of the neurovascular bundle were most indicative of extracapsular extension. Reader experience plays an important role in the ability to interpret prostate MR images and is an important contributor to interobserver variability.

Cited by 268 publications

References 0 publications

Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

Combined magnetic resonance imaging and spectroscopic imaging approach to molecular imaging of prostate cancer

The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate

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