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Accuracy of MRI without intracavernosal prostaglandin E1 injection in staging, preoperative evaluation, and operative planning of penile cancer

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Abstract

Purpose

To evaluate the performance of non-erectile MRI in staging and preoperative evaluation of penile carcinomas, compared to postoperative histopathology.

Methods

In this retrospective study, MRI scans of patients who had undergone surgery for penile carcinoma (n = 54) between January 2012 and April 2018 were read by two radiologists; and disagreement was solved in the presence of a third experienced radiologist. Data necessary for preoperative evaluation and staging were collected and compared with final postoperative histology and the type of surgery performed. All MRI had been performed without intracavernosal injection of prostaglandin E1 and with IV Gadolinium, as per local protocol.

Results

54 patients were included in the study (mean age 57.52 ± 12.78). The number of patients with T1, T2, and T3 staging in histopathology were 32, 14, and 8. Moderate interobserver agreement was found for staging, disease-free penile length, and all subsites except urethra, which had weak agreement. Strong agreement of consensus MRI with final histopathological staging was found (49/54, weighted κ = 0.85), with high sensitivity and specificity. Sensitivity and specificity for involvement of corpus spongiosum, corpora cavernosa, and urethra were 95.5% and 93.8%, 87.5% and 97.8%, and 90.9% and 86.1%, respectively. Sensitivity (89.6%) and specificity (100%) of MRI for predicting adequate disease-free penile length were high.

Conclusion

There were acceptable interobserver agreement and good diagnostic performance of MRI for staging and preoperative assessment without intracavernosal injection, especially for higher stages and higher degrees of invasion which require more extensive surgery.

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Data availability

All data and material used are available with the parent Institute.

Code availability

Software used are either freely available online or available with the hospital.

Abbreviations

PGE1 :

Prostaglandin E1

IV :

Intravenous

References

  1. Hanchanale V, Yeo L, Subedi N, Smith J, Wah T, Harnden P, Bhattarai S, Chilka S, Eardley I (2016) The accuracy of magnetic resonance imaging (MRI) in predicting the invasion of the tunica albuginea and the urethra during the primary staging of penile cancer. BJU Int 117:439–443

    Article  Google Scholar 

  2. Amin MB, Edge SB (2017) AJCC cancer staging manual. springer

  3. Hakenberg OW, Compérat E, Minhas S, Necchi A, Protzel C, Watkin N (2018) EAU Guidelines on Penile Cancer. EAU Guidelines

  4. Lont AP, Besnard APE, Gallee MPW, van Tinteren H, Horenblas S (2003) A comparison of physical examination and imaging in determining the extent of primary penile carcinoma. BJU Int 91:493–495

    Article  CAS  Google Scholar 

  5. Ficarra V, Righetti R, D’Amico A, Pilloni S, Balzarro M, Schiavone D, Malossini G, Mobilio G (2000) General state of health and psychological well-being in patients after surgery for urological malignant neoplasms. Urol Int 65:130–134

    Article  CAS  Google Scholar 

  6. Scardino E, Villa G, Bonomo G, Matei DV, Verweij F, Rocco B, Varela R, de Cobelli O (2004) Magnetic resonance imaging combined with artificial erection for local staging of penile cancer. Urology 63:1158–1162

    Article  CAS  Google Scholar 

  7. Kirkham A (2012) MRI of the penis. Br J Radiol 85 Spec No 1:S86–93

  8. Linet OI, Neff LL (1994) Intracavernous prostaglandin E1 in erectile dysfunction. Clin Investig 72:139–149

    Article  CAS  Google Scholar 

  9. Kunelius P, Lukkarinen O (1999) Intracavernous self-injection of prostaglandin E1 in the treatment of erectile dysfunction. Int J Impot Res 11:21–24

    Article  CAS  Google Scholar 

  10. Muruve N, Hosking DH (1996) Intracorporeal phenylephrine in the treatment of priapism. J Urol 155:141–143

    Article  CAS  Google Scholar 

  11. Krishna S, Shanbhogue K, Schieda N, Morbeck F, Hadas B, Kulkarni G, McInnes MD, Baroni RH (2020) Role of MRI in Staging of Penile Cancer. J Magn Reson Imaging https://doi.org/10.1002/jmri.27060

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lucchesi FR, Reis RB, Faria EF, Machado RD, Rossini RR, Borregales LD, Silva GEB, Muglia VF (2017) Incremental value of MRI for preoperative penile cancer staging. J Magn Reson Imaging 45:118–124

    Article  Google Scholar 

  13. Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17:1471–1474

  14. Sun M, Djajadiningrat RS, Alnajjar HM, Trinh Q-D, Graafland NM, Watkin N, Karakiewicz PI, Horenblas S (2015) Development and external validation of a prognostic tool for prediction of cancer-specific mortality after complete loco-regional pathological staging for squamous cell carcinoma of the penis. BJU Int 116:734–743

    Article  Google Scholar 

  15. Leijte JAP, Gallee M, Antonini N, Horenblas S (2008) Evaluation of current TNM classification of penile carcinoma. J Urol 180:933–8; discussion 938

  16. Pretorius ES, Siegelman ES, Ramchandani P, Banner MP (2001) MR imaging of the penis. Radiographics 21 Spec No:S283–98; discussion S298–9

  17. Philippou P, Shabbir M, Malone P, Nigam R, Muneer A, Ralph DJ, Minhas S (2012) Conservative surgery for squamous cell carcinoma of the penis: resection margins and long-term oncological control. J Urol 188:803–808

    Article  Google Scholar 

  18. Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N (2015) EAU guidelines on penile cancer: 2014 update. Eur Urol 67:142–150

    Article  Google Scholar 

  19. Guimarães GC, Rocha RM, Zequi SC, Cunha IW, Soares FA (2011) Penile cancer: epidemiology and treatment. Curr Oncol Rep 13:231–239

    Article  Google Scholar 

  20. Solsona E, Bahl A, Brandes SB, Dickerson D, Puras-Baez A, van Poppel H, Watkin NA (2010) New developments in the treatment of localized penile cancer. Urology 76:S36–42

    Article  Google Scholar 

  21. Engelsgjerd JS, LaGrange CA (2019) Cancer, Penile. StatPearls

  22. McHugh ML (2012) Interrater reliability: the kappa statistic. Biochem Med 22:276–282

    Article  Google Scholar 

  23. Kayes O, Minhas S, Allen C, Hare C, Freeman A, Ralph D (2007) The role of magnetic resonance imaging in the local staging of penile cancer. Eur Urol 51:1313–8; discussion 1318–9

  24. Bozzini G, Provenzano M, Romero Otero J, et al (2016) Role of Penile Doppler US in the Preoperative Assessment of Penile Squamous Cell Carcinoma Patients: Results From a Large Prospective Multicenter European Study. Urology 90:131–135

    Article  Google Scholar 

  25. Horenblas S, Kröger R, Gallee MP, Newling DW, van Tinteren H (1994) Ultrasound in squamous cell carcinoma of the penis; a useful addition to clinical staging? A comparison of ultrasound with histopathology. Urology 43:702–707

    Article  CAS  Google Scholar 

  26. Velazquez EF, Soskin A, Bock A, Codas R, Cai G, Barreto JE, Cubilla AL (2005) Epithelial abnormalities and precancerous lesions of anterior urethra in patients with penile carcinoma: a report of 89 cases. Mod Pathol 18:917–923

    Article  Google Scholar 

  27. Monteiro LL, Skowronski R, Brimo F, Carvalho P da C Neto, Vasconcelos RAL, Pacheco CRCV, Calado AA, Kassouf W (2021) Erectile function after partial penectomy for penile cancer. Int Braz J Urol 47:515–522

    Article  Google Scholar 

  28. Yu C, Hequn C, Longfei L, Minfeng C, Zhi C, Feng Z, Jinbo C, Lin Q, Xiongbing Z (2016) Sexual Function after Partial Penectomy: A Prospectively Study From China. Sci Rep 6:21862

    Article  Google Scholar 

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Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Department of Radiology, Tata Medical Center, 14 MAR (E-W), Rajarhat, Newtown, West Bengal, Kolkata, 700160, India

    Priya Ghosh, Aditi Chandra, Sumit Mukhopadhyay, Argha Chatterjee, Dayananda Lingegowda, Anisha Gehani, Bharat Gupta & Saugata Sen

  2. Department of Urological Oncology, Tata Medical Center, 14 MAR (E-W), Rajarhat, Newtown, Kolkata, West Bengal, 700160, India

    Sujoy Gupta

  3. Department of Pathology, Tata Medical Center, 14 MAR (E-W), Rajarhat, Newtown, Kolkata, West Bengal, 700160, India

    Divya Midha

Authors
  1. Priya Ghosh
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  10. Saugata Sen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by P. G, S. M, and A. C. The first draft of the manuscript was written by P. G and all authors commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Priya Ghosh.

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Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This is an observational study. The protocol was submitted to the Institutional Review Board and the Board decided to issue protocol waiver (IRB review exemption) for the study.

Consent to participate

Taken. No patient identifiable data have been used in the submission. Protocol waiver was issued by the IRB.

Consent for publication

Taken. No patient identifiable data have been used in the submission. Protocol waiver was issued by the IRB.

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Ghosh, P., Chandra, A., Mukhopadhyay, S. et al. Accuracy of MRI without intracavernosal prostaglandin E1 injection in staging, preoperative evaluation, and operative planning of penile cancer. Abdom Radiol 46, 4984–4994 (2021). https://doi.org/10.1007/s00261-021-03194-6

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  • DOI: https://doi.org/10.1007/s00261-021-03194-6

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