Prostate Cancer Staging: Should MR Imaging Be Used?—A Decision Analytic Approach

Jager, Gerrit J.; Severens, Johan L.; Thornbury, John R.; Rosette, J.J.M.H.C. de la; Ruijs, Sjef H. J.; Barentsz, Jelle O.

doi:10.1148/radiology.215.2.r00ap09445

Cited by 113 publications

(61 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This procedure was uniformly carried out for all cases, even when the radical prostatectomy data were available. We did not use T 2 -weighted MR images to define tumor location, as this is considered to be somewhat unreliable (4). Instead, we used T 2 -weighted MR images to identify normal PZ and CG; however, we always confirmed by histology that the chosen location indeed corresponded to normal tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Although the development of endorectal coils significantly improved the image quality required for accurate diagnosis (2), the sensitivity and specificity of this technique have been variable (3) and its diagnostic value for staging prostate cancer remains under investigation (4). Therefore, several MRI-based techniques have been investigated recently with the aim to improve tumor delineation and thus provide more reliable staging and the ability to predict the grade of tumor.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

Magnetic Resonance Imaging

245

192

View full text Add to dashboard Cite

Purpose:To determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI provides higher diagnostic sensitivity for prostate cancer than each technique alone. Materials and Methods:Fourteen patients with a clinical suspicion of prostate cancer underwent endorectal MRI on a 1.5T scanner prior to transrectal ultrasound (TRUS)-guided biopsies. The average values of the apparent diffusion coefficient (ADC, calculated from b-values of 0 and 600), K trans , v e , maximum gadolinium (Gd) concentration, onset time, mean gradient, and maximum enhancement were determined. Correlation with histology was based on biopsy (six patients) and prostatectomy specimen (eight patients) results. The Tukey-Kramer test was used for statistical analysis. Results:The average values of all MRI parameters, except v e and maximum Gd concentration, showed significant differences between tumor and normal prostate. The sensitivity and specificity values were respectively 54% (35-72%) and 100% (95-100%) for the ADC data, and 59% (39 -77%) and 74% (63-83%) for the DCE data. When both ADC and DCE results were combined, the sensitivity increased to 87% (68 -95%) and specificity decreased to 74% (62-83%). Conclusion:All but two DW-and DCE-MRI parameters showed significant differences between tumor and normal prostate. Combining both techniques provides better sensitivity, with a small decrease in specificity.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

Magnetic Resonance Imaging

245

192

View full text Add to dashboard Cite

show abstract

“…Three studies were in breast cancer (publication dates 1997 to 2003) (14)(15)(16), seven were in colorectal cancer (publication dates 2000 to 2011) (17)(18)(19)(20)(21)(22)(23) and seven were in prostate cancer (publication dates 2000 to 2012) (24)(25)(26)(27)(28)(29)(30). Two of the three breast cancer studies were set in the United States (14;16), and one was in Norway (15).…”

Section: Resultsmentioning

confidence: 99%

Are Policy Decisions on Surgical Procedures Informed by Robust Economic Evidence? A Systematic Review

Ara¹,

Basarir

Keetharuth

et al. 2014

Int J Technol Assess Health Care

View full text Add to dashboard Cite

Objectives: The aim of this study was to examine the empirical and methodological cost-effectiveness evidence of surgical interventions for breast, colorectal, or prostate cancer.Methods: A systematic search of seven databases including MEDLINE, EMBASE, and NHSEED, research registers, the NICE Web site and conference proceedings was conducted in April 2012. Study quality was assessed in terms of meeting essential, preferred and UK NICE specific requirements for economic evaluations.Results: The seventeen (breast = 3, colorectal = 7, prostate = 7) included studies covered a broad range of settings (nine European; eight non-European) and six were published over 10 years ago. The populations, interventions and comparators were generally well defined. Very few studies were informed by literature reviews and few used synthesized clinical evidence. Although the interventions had potential differential effects on recurrence and mortality rates, some studies used relatively short time horizons. Univariate sensitivity analyses were reported in all studies but less than a third characterized all uncertainty with a probabilistic sensitivity analysis. Although a third of studies incorporated patients’ health-related quality of life data, only four studies used social tariff values.Conclusions: There is a dearth of recent robust evidence describing the cost-effectiveness of surgical interventions in the management of breast, colorectal and prostate cancers. Many of the recent publications did not satisfy essential methodological requirements such as using clinical evidence informed by a systematic review and synthesis. Given the ratio of potential benefit and harms associated with cancer surgery and the volume of resources consumed by these, there is an urgent need to increase economic evaluations of these technologies.

show abstract

“…[25][26][27] This approach has also been shown to be a costeffective both for those at intermediate and at high risk of having extracapsular spread. 27 Other indications include patient selection for brachytherapy, where disease must be organ-confined and tumour volume accurately assessed. 28 MRI has also been used to guide and assess seed implantation.…”

Section: Staging Accuracy and Indicationsmentioning

confidence: 99%

Magnetic resonance imaging in prostate cancer

Heenan

2004

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

With the recently published National Institute of Clinical Excellence guidelines, it is now generally accepted that magnetic resonance imaging (MRI) is the imaging method of choice for staging prostate cancer in patients for whom radical treatment is being considered. MRI offers the single most accurate assessment of local disease and regional metastatic spread. As well as detecting extraprostatic extension, this technique can locate the site of intraprostatic disease, which may prove useful in planning disease-targeting therapies currently being developed. However, numerous studies have reported widely varying accuracies indicating that MRI is not the perfect imaging modality; microscopic and early macroscopic invasion cannot be reliably shown using current technology. The role of MRI including advantages, limitations and future developments will be discussed.

show abstract

Prostate Cancer Staging: Should MR Imaging Be Used?—A Decision Analytic Approach

Abstract: It is not yet conclusively determined whether preoperative MR staging is appropriate, but results of decision analysis suggest that MR staging is cost-effective for men with moderate or high prior probability of extracapsular disease.

Cited by 113 publications

References 48 publications

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Are Policy Decisions on Surgical Procedures Informed by Robust Economic Evidence? A Systematic Review

Magnetic resonance imaging in prostate cancer

Contact Info

Product

Resources

About