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Evaluation of MR elastography for prediction of lymph node metastasis in prostate cancer

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Abstract

Purpose

To assess the relationship between MRE stiffness of prostate cancer (PCa) and the extent of lymph node metastasis (LNM) in patients with PCa undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND).

Materials

The local institutional review board approved this retrospective study. We retrospectively analyzed 49 patients, who had undergone MRE, mpMRI and pelvic MRI on a 3.0 T MRI scanner, with histopathological confirmed PCa after RP (from June 2015 to December 2019). For each patient, preoperative clinical data and characteristics of MRE, mpMRI and pelvic MRI were recorded. Independent-samples t test, univariate and multivariate logistic regression analyses were performed. And receiver operating characteristic (ROC) analysis were performed to compare the diagnostic performances of multivariate models with the Briganti 2019 nomogram.

Results

PCa MRE stiffness and maximum diameter were independent predictors of LNM. When PCa MRE stiffness at 60 Hz (odds ratio [OR] = 20.223, P = 0.013) and maximum diameter (OR = 4.575, P = 0.046) were combined, the sensitivity and specificity were 100% and 91.9% to predict LNM. When PCa MRE stiffness at 90 Hz (OR = 7.920, P = 0.013) and maximum diameter (OR = 2.810, P = 0.045) were combined, the sensitivity and specificity were 100% and 86.5% to predict LNM. The areas under curves (AUCs) of the combinations were higher than the AUC of the Briganti 2019 nomogram (0.982 vs. 0.904, P = 0.040 [60 Hz]; 0.975 vs. 0.904, P = 0.060 [90 Hz], respectively).

Conclusions

MRE-based assessment of PCa stiffness may be useful for predicting LNM of PCa preoperatively and noninvasively.

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Abbreviations

MRE:

MR elastography

mpMRI:

Multi-parametric MRI

PCa:

Prostate cancer

LNM:

Lymph node metastasis

RP:

Radical prostatectomy

ePLND:

Extended pelvic lymph node dissection

ECM:

Extracellular matrix

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Funding

The authors state that this study has received funding by National Natural Science Foundation of China grant 91959118 (JW), Science and Technology Program of Guangzhou, China grant 201704020016 (JW), SKY Radiology Department International Medical Research Foundation of China Z-2014-07-1912-15 (JW), Clinical Research Foundation of the 3rd Affiliated Hospital of Sun Yat-sen University YHJH201901 (JW) and Key Research and Development Program of Guangdong Province 2019B020235002 (JW).

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Authors and Affiliations

  1. Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No 600, Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China

    Bing Hu, Ying Deng, Jingbiao Chen, Sichi Kuang, Wenjie Tang, Bingjun He, Linqi Zhang, Yuanqiang Xiao & Jin Wang

  2. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Jun Chen, Phillip Rossman, Arvin Arani, Ziying Yin, Kevin J. Glaser, Meng Yin, Sudhakar K. Venkatesh & Richard L. Ehman

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  1. Bing Hu
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  2. Ying Deng
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  17. Jin Wang
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Contributions

Dr. BH and Dr. YD contributed equally to the study concept and design, acquisition of data, statistical analysis, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

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Correspondence to Jin Wang.

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Hu, B., Deng, Y., Chen, J. et al. Evaluation of MR elastography for prediction of lymph node metastasis in prostate cancer. Abdom Radiol 46, 3387–3400 (2021). https://doi.org/10.1007/s00261-021-02982-4

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