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European Radiology

, Volume 23, Issue 7, pp 2019–2029 | Cite as

Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study

  • Flavie Bratan
  • Emilie Niaf
  • Christelle Melodelima
  • Anne Laure Chesnais
  • Rémi Souchon
  • Florence Mège-Lechevallier
  • Marc Colombel
  • Olivier RouvièreEmail author
Urogenital

Abstract

Objectives

To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.

Methods

One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n = 71) or 3 T (n = 104), with (n = 58) or without (n = 117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.

Results

Readers identified 192–214/362 cancers, with 130–155 false positives. Detection rates for tumours of <0.5 cc (cm3), 0.5–2 cc and >2 cc were 33–45/155 (21–29 %), 15–19/35 (43–54 %) and 8–9/12 (67–75 %) for Gleason ≤6, 17/27 (63 %), 42–45/51 (82–88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P < 0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P < 0.005) and aggressiveness of tumours (P < 0.00001).

Conclusions

Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.

Key Points

• Prostate cancer volume, Gleason score, architecture and location are MRI predictors of detection.

• Field strength and coils used do not influence the tumour detection rate.

• Multiparametric MRI is accurate for detecting aggressive tumours.

• A subjective suspicion score can stratify the risk of malignancy and tumour aggressiveness.

Keywords

Prostate cancer Magnetic resonance imaging Tumour localisation Gleason score Tumour volume 

Abbreviations

Mp-MRI

Multiparametric magnetic resonance imaging

T2w imaging

T2-weighted imaging

Dw imaging

Diffusion-weighted imaging

DCE imaging

Dynamic contrast enhanced imaging

MRS

Magnetic resonance spectroscopy

FA

Focal abnormality

FP

False positive

FN

False negative

TP

True positive

SSS

Subjective suspicion score

PZ

Peripheral zone

TZ

Transition zone

ADC

Apparent diffusion coefficient

OR

Odds ratio

PSA

Prostate-specific antigen

PPA

Pelvic phased-array

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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Flavie Bratan
    • 1
    • 2
  • Emilie Niaf
    • 2
    • 9
  • Christelle Melodelima
    • 3
  • Anne Laure Chesnais
    • 4
  • Rémi Souchon
    • 2
  • Florence Mège-Lechevallier
    • 4
  • Marc Colombel
    • 5
    • 6
    • 7
  • Olivier Rouvière
    • 1
    • 2
    • 5
    • 6
    • 8
    Email author
  1. 1.Department of Urinary and Vascular RadiologyHôpital Edouard Herriot, Hospices Civils de LyonLyonFrance
  2. 2.LabTauInserm, U1032LyonFrance
  3. 3.Laboratoire d’Ecologie Alpine, CNRS UMR 5553Université Joseph FourierGrenobleFrance
  4. 4.Department of PathologyHôpital Edouard Herriot, Hospices Civils de LyonLyonFrance
  5. 5.Université de LyonLyonFrance
  6. 6.Faculté de Médecine Lyon EstUniversité Lyon 1LyonFrance
  7. 7.Department of UrologyHôpital Edouard Herriot, Hospices Civils de LyonLyonFrance
  8. 8.Service de Radiologie Urinaire et Vasculaire, Pavillon PHôpital E. HerriotLyon Cedex 03France
  9. 9.CREATIS, CNRS UMR5220, Inserm U1044, INSA-LyonVilleurbanneFrance

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