Value of Endorectal Magnetic Resonance Imaging at 3T for the Local Staging of Prostate Cancer

Abstract

Purpose: To assess the accuracy of endorectal 3?T magnetic resonance imaging (MRI) in detecting extracapsular extension (ECE) and seminal vesicle invasion (SVI) of prostate cancer (PCa). Materials and Methods: 38 consecutive patients with biopsy-proven PCa underwent multiparametric endorectal MRI at 3?T prior to prostatectomy. Two readers (A with nine years of experience and B with four) used established criteria for ECE and SVI to diagnose the extent of local disease in six regions (apical, dorsolateral, basal; left and right each) with the highest chance of ECE. The standard of reference was provided by intraoperative frozen section analysis and prostatectomy specimens. Results: Histopathology revealed ECE in 15 of the 222 regions (10 of 37 patients) and SVI in 8 of 74?potential regions (5 of 37 patients). The sensitivity, specificity, and accuracy in detecting ECE for reader A/B were 93?%/67?%, 92?%/95?% and 92?%/93?% per region and 90?%/80?%, 74?%/82?% and?78?%/81?% per patient, respectively. The corresponding values for the detection of SVI were 80?%/100?%, 96?%/99?% and 95?%/97?%, respectively. Conclusion: Endorectal 3?T MRI is a highly reliable noninvasive technique for the local staging of PCa. Key points: ??Endorectal 3?T MRI provided high accuracy for the local staging of prostate cancer. ??The sensitivity in detecting extracapsular tumor growth per patient was 80?% or higher. ??The specificity in detecting extracapsular extension (pT3 stage) was good. Citation Format: ??Otto J, Th?rmer G, Seiwerts M et?al. Value of Endorectal Magnetic Resonance Imaging at 3T?for the Local Staging of Prostate Cancer. Fortschr R?ntgenstr 2014; 186: 795???802

The Role of Magnetic Resonance Imaging and Positron Emission Tomography/Computed Tomography in the Primary Staging of Newly Diagnosed Prostate Cancer: A Systematic Review of the Literature

“…Reader experience. Interpretation of mpMRI might vary between different readers, with an assumed benefit for radiologists with high level of MRI experience [12,30,58,65,71,73,77]. Although several studies reported better performance among radiologists with high level of experience, most had only small sample size with wide and overlapping confidence intervals.…”

Oncologic Outcomes after Radical Retropubic Prostatectomy in Patients Meeting the Epstein Criteria

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Diagnostische accuratesse van multiparametrische magnetic resonance imaging (mpMRI) voor de lokale stadiëring van prostaatkanker in een multicenter onderzoek

“…De uitkomst van de diagnostische procedure is sterk afhankelijk van de ervaring van de beoordelaar(s) [8]. Eerder onderzoek toonde aan dat de interobserverovereenkomst tussen een ervaren en onervaren beoordelaar van mpMRI slecht was [8,9]. De Cohen's kappa in deze studie was 0,0129, waarbij een kappa van 0 betekent dat de overeenkomst tussen beoordelingen volledig op kans berust, en een kappa van 1 dat de beoordelingen volledig met elkaar overeenkomen.…”