La radiologia medica

, Volume 123, Issue 10, pp 778–787 | Cite as

Multiparametric magnetic resonance imaging versus Partin tables and the Memorial Sloan-Kettering cancer center nomogram in risk stratification of patients with prostate cancer referred to external beam radiation therapy

  • Rossano GiromettiEmail author
  • Martina Pancot
  • Marco Andrea Signor
  • Martina Urbani
  • Luca Balestreri
  • Chiara Zuiani



To evaluate the agreement between multiparametric Magnetic Resonance Imaging (mpMRI), Partin tables (PT) and the Memorial Sloan Kettering Cancer Center nomogram (MSKCCn) in assessing risk category in prostate cancer (PCa) patients referred to External Beam Radiotherapy (EBRT).

Materials and methods

In this bicentric study, we prospectively enrolled 80 PCa patients who underwent pre-EBRT mpMRI on a 3.0T magnet with a multiparametric protocol including high-resolution, multiplanar T2-weighted sequences, diffusion-weighted imaging and dynamic contrast-enhanced imaging. National comprehensive cancer network risk categories were assessed using prostate-specific-antigen level, Gleason score and the T-stage as defined by mpMRI or nomograms. Cohen’s kappa statistic was used to calculate the agreement between mpMRI and nomograms in assessing the T-stage (organ-confined (OC) vs. non-organ-confined (nOC) disease) and risk category (≤ low risk vs. intermediate risk vs. ≥ high risk).


mpMRI showed poor agreement with PT and MSKCCn in assessing nOC versus OC (k = 0.16 for both), translating into an mpMRI-induced reclassification of PT- and MSKCCn-related risk category in 36.3% (k = 0.43) and 41.3% (k = 0.31) of cases, respectively, with most changes occurring towards intermediate risk category.


mpMRI showed low agreement with nomograms as a tool to stratify PCa risk, leading to significant risk reclassification. Assuming that mpMRI is a more reliable surrogate standard of reference for pathology, this technique should refine or replace nomograms in risk classification before EBRT.


Prostate cancer Magnetic resonance imaging Nomograms Cancer T stage Risk assessment External beam radiation therapy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have conflict of interest to disclose.

Ethical standards

All the procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. Moreover, this study was approved by our referring Ethical Committee, and patients gave informed consent to participation.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  1. 1.Institute of Radiology, Department of MedicineUniversity of UdineUdineItaly
  2. 2.Department of Oncological Radiation TherapyAzienda Ospedaliero-Universitaria Santa Maria della MisericordiaUdineItaly
  3. 3.Department of Oncologic Radiation Therapy and Diagnostic ImagingCentro di Riferimento OncologicoAvianoItaly

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