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Multiparametric magnetic resonance imaging for prostate cancer—a comparative study including radical prostatectomy specimens

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Abstract

Purpose

To evaluate the diagnostic and staging ability of multiparametric MRI (mpMRI) compared to radical prostatectomy (RP) specimens after dissemination of this technology to several centres. mpMRI is an evolving technique aiming to improve upon the diagnostic sensitivity of prostate biopsy for the diagnosis of prostate cancer. Differences in interpretation, expertise and application of mpMRI are responsible for the range of reported results.

Methods

This retrospective clinical study was conducted with consecutive patients through an electronic database of tertiary hospitals and adjacent private urology practices in Australia. Patients having undergone RP were assessed for the presence of a pre-operative mpMRI performed between 2013 and 2015 which was evaluated against the reference standard of the RP whole-mount specimen. MRI reports were evaluated using the Prostate Imaging Reporting and Data System (PI-RADS).

Results

In our cohort of 152 patients, the sensitivity and specificity of mpMRI (PI-RADS ≥ 4) for prostate cancer (Gleason ≥ 4 + 3) detection were 83 and 47%, respectively. For the identification of extraprostatic disease, the sensitivity and specificity were 29 and 94%, respectively.

Conclusion

These results represent a ‘real-world’ approach to mpMRI and appear comparable to other single-centre studies. MRI staging information should be interpreted in context with other risk factors for extraprostatic disease. mpMRI has a useful role as an adjunct for prostate cancer diagnosis and directing management towards improving patient outcomes.

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Acknowledgements

The authors would like to acknowledge the assistance of Dr Colin Styles MBBS FRANZCR and Dr Peter Smith MBBS FRANZCR from the University of Melbourne department of radiology.

Authors’ contributions

LT was involved in data collection and data analysis and wrote the manuscript. NP was involved in data analysis and edited the manuscript. MP edited the manuscript and was involved in manuscript revisions and data processing. NK was involved in data collection. MW was involved in protocol/project management and edited the manuscript. KC was involved in data collection. LH was involved in data collection. DMB was involved in protocol/project management and data collection and edited the manuscript. NL was involved in protocol/project management and data collection and edited the manuscript.

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Authors and Affiliations

  1. Urology Unit, Department of Surgery, University of Melbourne, Melbourne, Australia

    Liam Toner, Nathan Papa, Marlon Perera, Nikolas Katelaris, Mahesha Weerakoon, Damien M. Bolton & Nathan Lawrentschuk

  2. Department of Radiology, Peter MacCallum Cancer Centre, Melbourne, Australia

    Kwang Chin

  3. Urology, Renal and Vascular Clinical Unit, Freemasons Campus, Epworth Healthcare, Melbourne, Australia

    Laurence Harewood

  4. Olivia Newton-John for Cancer Research Institute, Heidelberg Branch, Austin Health, Melbourne, Australia

    Damien M. Bolton & Nathan Lawrentschuk

  5. Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia

    Nathan Lawrentschuk

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  1. Liam Toner
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  2. Nathan Papa
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  3. Marlon Perera
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  4. Nikolas Katelaris
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  5. Mahesha Weerakoon
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  6. Kwang Chin
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  7. Laurence Harewood
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  8. Damien M. Bolton
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  9. Nathan Lawrentschuk
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Corresponding author

Correspondence to Liam Toner.

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Conflict of interest

The authors declare that they have no conflict of interest. This research was performed in the spare time of all authors without any financial support.

Ethical approval

Ethics approval was obtained from our institution’s ethical review board (LNR/15/Austin/234).

Informed consent

Informed consent was not required as it was a de-identified retrospective analysis.

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Toner, L., Papa, N., Perera, M. et al. Multiparametric magnetic resonance imaging for prostate cancer—a comparative study including radical prostatectomy specimens. World J Urol 35, 935–941 (2017). https://doi.org/10.1007/s00345-016-1960-x

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  • DOI: https://doi.org/10.1007/s00345-016-1960-x

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