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Prediction of biochemical recurrence after radical prostatectomy with PI-RADS version 2 in prostate cancers: initial results

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Abstract

Objectives

To determine whether the Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) helps predict biochemical recurrence (BCR) after radical prostatectomy for prostate cancer (PCa).

Methods

We included 158 patients with PCa who underwent magnetic resonance imaging (MRI) and radical prostatectomy (RP). Clinical (prostate-specific antigen, greatest percentage of core, and percentage of positive core number), PI-RADSv2 score on MRI, and surgical parameters (Gleason score, extracapsular extension, seminal vesicle invasion, and tumour volume) were investigated. Univariate and multivariate analyses using Cox’s proportional hazards model were performed to assess parameters predictive of BCR (two consecutive prostate specific antigens ≥0.2 ng/ml). Kaplan-Meier survival curves were analyzed.

Results

The rate of BCR was 13.3 % (21/158) after surgery (median follow-up, 25 months; range, 12–36). No subject with a PI-RADS score <4 had BCR. In univariate analysis, all parameters were significant for BCR (p < 0.05), except seminal vesicle invasion (p = 0.254). Meanwhile, PI-RADS score was the only independent parameter for BCR in multivariate analysis (p < 0.05). Two-year, BCR-free survival post-RP was significantly lower for PI-RADS ≥4 (84.7–85.5 %) than for PI-RADS <4 (100 %; p < 0.05).

Conclusion

As a preoperative imaging tool, PI-RADSv2 may be useful to predict BCR after radical prostatectomy for PCa.

Key Points

• No subject with PI-RADS <4 had BCR after RP

• PI-RADSv2 was the only predictor of BCR in multivariate analysis

• Two-year, BCR-free survival following RP was lower for PI-RADS≥4 than for PI-RADS<4

• Inter-rater agreement was good for PI-RADS ≥4 or not

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Abbreviations

RP:

Radical prostatectomy

PCa:

Prostate cancer

BCR:

Biochemical recurrence

MRI:

Magnetic resonance imaging

ADC:

Apparent diffusion coefficient

T2WI:

T2-weighted imaging

DWI:

Diffusion-weighted imaging

DCEI:

Dynamic contrast-enhanced imaging

PI-RADS:

Prostate Imaging Reporting and Data System

PSA:

Prostate-specific antigen

GS:

Gleason score

ECE:

Extracapsular extension

SVI:

Seminal vesicle invasion

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Acknowledgments

The scientific guarantor of this publication is Young Taik Oh. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, cross sectional study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea

    Sung Yoon Park, Young Taik Oh & Dae Chul Jung

  2. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    Nam Hoon Cho

  3. Department of Urology, Yonsei University College of Medicine, Seoul, Korea

    Young Deuk Choi, Koon Ho Rha & Sung Joon Hong

  4. Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Young Taik Oh

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  1. Sung Yoon Park
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Correspondence to Young Taik Oh.

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Park, S.Y., Oh, Y.T., Jung, D.C. et al. Prediction of biochemical recurrence after radical prostatectomy with PI-RADS version 2 in prostate cancers: initial results. Eur Radiol 26, 2502–2509 (2016). https://doi.org/10.1007/s00330-015-4077-5

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