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Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

To assess the value of dynamic contrast-enhanced (DCE) combined with T2-weighted (T2W) endorectal coil (ERC) magnetic resonance imaging (MRI) at 3 T for determining extracapsular extension (ECE) of prostate cancer.

Methods

In this IRB-approved study, ERC 3-T MRI of the prostate was performed in 108 patients before radical prostatectomy. T2W fast spin-echo and DCE 3D gradient echo images were acquired. The interpretations of readers with varied experience were analysed. MRI-based staging results were compared with radical prostatectomy histology. Descriptive statistics were generated for prediction of ECE and staging accuracies were determined by the area under the receiver-operating characteristic curve.

Results

The overall sensitivity, specificity, positive predictive value and negative predictive value for ECE were 75 %, 92 %, 79 % and 91 %, respectively. Diagnostic accuracy for staging was 86 %, 80 % and 91 % for all readers, experienced and less experienced readers, respectively.

Conclusions

ERC 3-T MRI of the prostate combining DCE and T2W imaging is an accurate pretherapeutic staging tool for assessment of ECE in clinical practice across varying levels of reader experience.

Key Points

• Endorectal coil (ERC) magnetic resonance imaging is widely used for imaging prostatic disease.

• ERC 3-T MRI is reasonably accurate for local prostate cancer staging.

• High diagnostic accuracy is achievable across different levels of reader experience.

• MRI facilitates therapeutic decisions in patients with prostate cancer.

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Abbreviations

AJCC:

American Joint Committee on Cancer

AUC:

area under the receiver-operating characteristic curve

DCE:

dynamic contrast-enhanced

DWI:

diffusion-weighted imaging

ECE:

extracapsular extension

ERC:

endorectal coil

IRB:

institutional review board

NIH:

National Institute of Health

NPV:

negative predictive value

PPV:

positive predictive value

T2W:

T2-weighted

3 T:

3 tesla

3TP:

three-time-point

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Acknowledgements

This study was supported by a grant from the National Institutes of Health (NIH) RO1 CA116465 and BNB was partially supported by Bayer Healthcare Pharmaceuticals. MGS was supported by NIH U01 CA11391. The authors had complete control of the data and the information submitted for publication.

The authors also acknowledge Doy Grobgeld and Hadassa Degani for supplying the software used to analyse the dynamic contrast-enhanced data, and Tania Velez, M.D. and Virginia Latting, M.D. for assistance in data collection.

Author information

Author notes

  1. B. Nicolas Bloch

    Present address: Department of Radiology, Boston Medical Center and Boston University, Boston, MA, USA

  2. Neil M. Rofsky

    Present address: Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8896, USA

Authors and Affiliations

  1. Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    B. Nicolas Bloch, Daniel N. Costa, Ivan Pedrosa, Martin P. Smith, Herbert Y. Kressel & Neil M. Rofsky

  2. Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Elizabeth M. Genega

  3. Department of General Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Long Ngo

  4. Department of Division of Urology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Martin G. Sanda & William C. DeWolf

  5. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Daniel N. Costa & Ivan Pedrosa

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  1. B. Nicolas Bloch
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Correspondence to Neil M. Rofsky.

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Bloch, B.N., Genega, E.M., Costa, D.N. et al. Prediction of prostate cancer extracapsular extension with high spatial resolution dynamic contrast-enhanced 3-T MRI. Eur Radiol 22, 2201–2210 (2012). https://doi.org/10.1007/s00330-012-2475-5

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  • DOI: https://doi.org/10.1007/s00330-012-2475-5

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