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Extracapsular extension on MRI indicates a more aggressive cell cycle progression genotype of prostate cancer

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Abstract

Purpose

To explore associations between magnetic resonance imaging (MRI) features of prostate cancer and expression levels of cell cycle genes, as assessed by the Prolaris® test.

Materials and methods

Retrospective analysis of 118 PCa patients with genetic testing of biopsy specimen and prostate MRI from 08/2013 to 11/2015. Associations between the cell cycle risk (CCR) score and MRI features [i.e., PI-RADSv2 score, extracapsular extension (ECE), quantitative metrics] were analyzed with Fisher’s exact test, nonparametric tests, and Spearman’s correlation coefficient. In 41 patients (34.7%), test results were compared to unfavorable features on prostatectomy specimen (i.e., Gleason group ≥ 3, ECE, lymph node metastases).

Results

Fifty-four (45.8%), 60 (50.8%), and 4 (3.4%) patients had low-, intermediate-, and high-risk cancers according to American Urological Association scoring system. Patients with ECE on MRI had significantly higher mean CCR scores (reader 1: 3.9 vs. 3.2, p = 0.015; reader 2: 3.6 vs. 3.2, p = 0.045). PI-RADSv2 scores and quantitative MRI features were not associated with CCR scores. In the prostatectomy subset, ECE on MRI (p = < 0.001–0.001) and CCR scores (p = 0.049) were significantly associated with unfavorable histopathologic features.

Conclusion

The phenotypic trait of ECE on MRI indicates a more aggressive genotype of prostate cancer.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Andreas G. Wibmer, Nicola L. Robertson, Hedvig Hricak & Hebert Alberto Vargas

  2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Junting Zheng & Marinela Capanu

  3. Myriad Genetics, Salt Lake City, UT, USA

    Steven Stone

  4. Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Behfar Ehdaie

  5. MDX Health, Irvine, CA, USA

    Michael K. Brawer

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  1. Andreas G. Wibmer
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Correspondence to Andreas G. Wibmer.

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Conflict of interest

Steve Stone is an employee of Myriad Genetics, Salt Lake City, UT, USA. Michael K Brawer is a former employee of Myriad Genetics, Salt Lake City, UT, USA. Andreas G Wibmer was supported by the Peter Michael Foundation.

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Wibmer, A.G., Robertson, N.L., Hricak, H. et al. Extracapsular extension on MRI indicates a more aggressive cell cycle progression genotype of prostate cancer. Abdom Radiol 44, 2864–2873 (2019). https://doi.org/10.1007/s00261-019-02023-1

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