Prostate carcinoma: assessment of diagnostic criteria for capsular penetration on endorectal coil MR images.

Outwater, Eric K.; Petersen, Robert O.; Siegelman, Evan S.; Gomella, Leonard G.; Chernesky, Chris E.; Mitchell, David

doi:10.1148/radiology.193.2.7972739

Cited by 163 publications

(80 citation statements)

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“…Accuracy levels ranged from 54% to 83%. In three ofthese studies, fast spin-echo MR images with an ERC were correlated with histopathologic mapping [12,14,16]. As an adjunct to staging, the volume of prostate cancer is also important for prognosis [17-1 9].…”

Section: Objectivementioning

confidence: 99%

Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

Jager

Ruijter²,

Kaa³

et al. 1996

American Journal of Roentgenology

237

112

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Section: Objectivementioning

confidence: 99%

Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

Jager

Ruijter²,

Kaa³

et al. 1996

American Journal of Roentgenology

237

112

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“…26 In fact, previous studies have shown that if a diagnosis of extraprostatic tumour spread is based solely on obvious findings, the high specificity may be associated with a downside of extremely poor sensitivity. 27 When stricter definitions were used, accuracy rates fell from an average sensitivity of 70%-80% to below 40% in one particular report. 28 Using contour deformity with only irregular margins as a criterion for capsular penetration, Chelsky et al 9 achieved an increase in specificity from 78% to 96%.…”

Section: Discussionmentioning

confidence: 98%

The predictability of T3 disease in staging MRI following prostate biopsy decreases in patients with high initial PSA and Gleason score

Ko¹,

Sung²,

Kang³

et al. 2011

Asian J Androl

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To obtain improved accuracy in predicting extracapsular extension (ECE) and seminal vesicle invasion (SVI), we evaluated the variables affecting the predictability of staging magnetic resonance imaging (MRI, phased-array coil) and estimated their impact on accuracy between preoperative MRI staging and histological outcome. A total of 121 patients with localized or locally advanced prostate cancer who underwent robotic radical prostatectomy (RALP) were included. Following transrectal biopsy, all enrolled patients had undergone MRI for staging work-up. After RALP, only 43.8% (53/121) of the patients were matched with the MRI predicted stage. Compared to the matched group in the prediction of ECE, the unmatched group had significantly higher initial prostate-specific antigen (PSA, 12.8 ng ml 21 versus 8.1 ng ml 21 , P50.048). In the prediction of SVI, initial PSA (8.1 ng ml 21 versus 17.3 ng ml 21 , P50.009) and biopsy Gleason score (6.5 versus 7.6, P50.035) were significantly higher in the unmatched group. When applying clinical cutoffs of initial PSA of 10 and 20 ng ml 21 , the accuracy of MRI in the prediction of ECE was decreased in the group with PSA over 20 ng ml 21 (75.6, 64.5 and 37.5%, P50.01), and this group had significantly decreased accuracy of MRI in the prediction of SVI (91.5, 77.4 and 37.5%, P,0.01). Applying the clinical cutoff of a Gleason score of 7, the accuracy of MRI in the prediction of SVI was decreased in the higher Gleason score group (93.9, 82.1 and 62.9%, P50.01). Thus, for these patient groups, to obtain margin negativity during radical prostatectomy, operative findings, rather than post-biopsy MRI images, may provide substantial information, implying a clinical advantage in conducting MRI before prostate biopsy.

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“…All operations were performed by one surgeon at one institution The criteria for capsular penetration included: low signal infiltration of the periprostatic fat on T1 images, focal bulging of the capsule adjacent to the tumour ( Fig. 1) and loss of signal within the seminal vesicles on T2-weighted images [9].…”

Section: Methodsmentioning

confidence: 99%

Does body‐coil magnetic‐resonance imaging have a role in the preoperative staging of patients with clinically localized prostate cancer?

Allen¹,

Hindley²,

Clovis³

et al. 2004

BJU International

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OBJECTIVETo investigate the accuracy and use of body‐coil magnetic resonance imaging (MRI) in the local staging of prostate cancer before radical prostatectomy (RP).PATIENTS AND METHODSFifty‐six patients undergoing RP were staged before surgery using body‐coil MRI; none was denied surgery on the basis of their scan results. All scans were reported before RP by one of three consultant radiologists and afterward by a colleague with a special interest in prostate MRI, unaware of the patients’ clinical details.RESULTSThe overall sensitivity of MRI at detecting extracapsular extension was 50% on general reporting and 72% when reported by the specialist radiologist; the respective specificities were 84% and 86%. Of the 55 patients included in the study, 18 (33%) had extracapsular disease on histological analysis. MRI was most accurate in the 17 patients at high‐risk (prostate‐specific antigen, PSA, >10 ng/mL and Gleason score ≥ 8) and eight at intermediate risk (PSA < 10 ng/mL and Gleason score 7). In the former group with specialist analysis, the sensitivity was 100%, although this decreased to 67% with general reporting. Both gave a specificity of 82%. Intermediate risk disease gave a sensitivity and specificity of 75%, irrespective of reporting method. The ability of MRI to detect extraprostatic tumour in the 30 low‐risk patients (PSA < 10 ng/mL and Gleason score 2–6) was poor; the sensitivity was 25% with general and 50% on specialist review, although both methods gave a specificity of >90%.CONCLUSIONBody‐coil MRI is sensitive and specific for identifying extracapsular extension of prostate cancer in patients with high‐ or intermediate‐risk disease. Patients at low risk frequently have microscopic extension which is not detected. Opinion from a radiologist with a special interest in prostate MRI can increase the reporting accuracy even when unaware of the patients’ clinical details.

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Prostate carcinoma: assessment of diagnostic criteria for capsular penetration on endorectal coil MR images.

Abstract: Sensitivity and specificity were generally low for the diagnostic criteria. The usefulness of endorectal coil MR imaging in staging prostate cancer may be limited by the lack of diagnostic signs that uniformly identify extracapsular penetration.

Cited by 163 publications

References 0 publications

Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology.

The predictability of T3 disease in staging MRI following prostate biopsy decreases in patients with high initial PSA and Gleason score

Does body‐coil magnetic‐resonance imaging have a role in the preoperative staging of patients with clinically localized prostate cancer?

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