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European Radiology
Erschienen in: European Radiology 6/2015

01.06.2015 | Urogenital

Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI: a correlation with histopathology

verfasst von: Lars Boesen, Elizaveta Chabanova, Vibeke Løgager, Ingegerd Balslev, Kari Mikines, Henrik S. Thomsen

Erschienen in: European Radiology | Ausgabe 6/2015

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Abstract

Objectives

To evaluate the diagnostic performance of preoperative multiparametric MRI with extracapsular extension (ECE) risk-scoring in the assessment of prostate cancer tumour stage (T-stage) and prediction of ECE at final pathology.

Materials and Methods

Eighty-seven patients with clinically localised prostate cancer scheduled for radical prostatectomy were prospectively enrolled. Multiparametric MRI was performed prior to prostatectomy, and evaluated according to the ESUR MR prostate guidelines by two different readers. An MRI clinical T-stage (cTMRI), an ECE risk score, and suspicion of ECE based on tumour characteristics and personal opinion were assigned. Histopathological prostatectomy results were standard reference.

Results

Histopathology and cTMRI showed a spearman rho correlation of 0.658 (p < 0.001) and a weighted kappa = 0.585 [CI 0.44;0.73](reader A). ECE was present in 31/87 (36 %) patients. ECE risk-scoring showed an AUC of 0.65–0.86 on ROC-curve for both readers, with sensitivity and specificity of 81 % and 78 % at best cutoff level (reader A), respectively. When tumour characteristics were influenced by personal opinion, the sensitivity and specificity for prediction of ECE changed to 61 %–74 % and 77 %-88 % for the readers, respectively.

Conclusions

Multiparametric MRI with ECE risk-scoring is an accurate diagnostic technique in determining prostate cancer clinical tumour stage and ECE at final pathology.

Key Points

• Multiparametric MRI is an accurate diagnostic technique for preoperative prostate cancer staging
• ECE risk scoring predicts extracapsular tumour extension at final pathology
• ECE risk scoring shows an AUC of 0.86 on the ROC-curve
• ECE risk scoring shows a moderate inter-reader agreement (K = 0.45)
• Multiparametric MRI provides essential knowledge for optimal clinical management
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Metadaten
Titel
Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI: a correlation with histopathology
verfasst von
Lars Boesen
Elizaveta Chabanova
Vibeke Løgager
Ingegerd Balslev
Kari Mikines
Henrik S. Thomsen
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3543-9

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