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

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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.

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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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Authors and Affiliations

  1. Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69437, France

    Flavie Bratan & Olivier Rouvière

  2. LabTau, Inserm, U1032, Lyon, 69003, France

    Flavie Bratan, Emilie Niaf, Rémi Souchon & Olivier Rouvière

  3. Laboratoire d’Ecologie Alpine, CNRS UMR 5553, Université Joseph Fourier, BP 53, Grenoble, 38041, France

    Christelle Melodelima

  4. Department of Pathology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69437, France

    Anne Laure Chesnais & Florence Mège-Lechevallier

  5. Université de Lyon, Lyon, 69003, France

    Marc Colombel & Olivier Rouvière

  6. Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, 69003, France

    Marc Colombel & Olivier Rouvière

  7. Department of Urology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69437, France

    Marc Colombel

  8. Service de Radiologie Urinaire et Vasculaire, Pavillon P, Hôpital E. Herriot, 5 Place d’Arsonval 69437, Lyon Cedex 03, France

    Olivier Rouvière

  9. CREATIS, CNRS UMR5220, Inserm U1044, INSA-Lyon, Villeurbanne, 69100, France

    Emilie Niaf

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  1. Flavie Bratan
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Correspondence to Olivier Rouvière.

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Bratan, F., Niaf, E., Melodelima, C. et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 23, 2019–2029 (2013). https://doi.org/10.1007/s00330-013-2795-0

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  • DOI: https://doi.org/10.1007/s00330-013-2795-0

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