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Feasibility of multiparametric prostate magnetic resonance imaging in the detection of cancer distribution: histopathological correlation with prostatectomy specimens.

Kitamura K, Muto S, Yokota I, Hoshimoto K, Kaminaga T, Noguchi T, Sugiura S, Ide H, Yamaguchi R, Furui S, Horie S - Prostate Int (2014)

Bottom Line: These results were compared with the histopathological findings for RP specimens.The area under the receiver operator characteristic curve analysis yielded a higher value for DWI (0.68) than for T2W (0.65), (1)H-MRS (0.54), or PBx (0.56).In 180 cancerous regions of RP specimens with false-negative PBx results, T2W+DWI had the highest positive rate (53.3%) compared with that of each sequence alone, including T2W (45.6%), DWI (41.1%), and (1)H-MRS (30.0%).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan ; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.

ABSTRACT

Purpose: To prevent overtreatment, it is very important to diagnose the precise distribution and characteristics of all cancer lesions, including small daughter tumors. The purpose of this study was to evaluate the efficacy of T2-weighted magnetic resonance imaging (T2W), diffusion-weighted magnetic resonance imaging (DWI), magnetic resonance spectroscopy ((1)H-MRS), and prostate biopsy (PBx) in the detection of intraprostatic cancer distribution.

Methods: All patients underwent T2W, DWI, (1)H-MRS, and PBx followed by radical prostatectomy (RP). Individual prostates were divided into 12 segmental regions, each of which was examined for the presence or absence of malignancy on the basis of T2W, DWI, (1)H-MRS, and PBx, respectively. These results were compared with the histopathological findings for RP specimens.

Results: We included 54 consecutive patients with biopsy-proven prostate cancer (mean age, 62.7 years; median prostate-specific antigen level, 5.7 ng/mL) in this study. We could detect cancer in 247 of 540 evaluable lesions. The area under the receiver operator characteristic curve analysis yielded a higher value for DWI (0.68) than for T2W (0.65), (1)H-MRS (0.54), or PBx (0.56). In 180 cancerous regions of RP specimens with false-negative PBx results, T2W+DWI had the highest positive rate (53.3%) compared with that of each sequence alone, including T2W (45.6%), DWI (41.1%), and (1)H-MRS (30.0%).

Conclusions: Multiparametric magnetic resonance imaging (T2W, (1)H-MRS, DWI) enables the detection of prostate cancer distribution with reasonable sensitivity and specificity. T2W+DWI was particularly effective in detecting cancer distribution with false-negative PBx results.

No MeSH data available.


Related in: MedlinePlus

Each prostate was divided into 12 segmented regions. For tumor localization, each prostate was divided into halves: right and left. Each half was further divided into 6 regions as follows: (A) outside peripheral zone (Pz) anterior, (B) outside Pz posterior, (C) inside Pz, (D) central transitional zone (Tz), (E) Tz anterior, (F) apex.
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f2-pi-2-4-188: Each prostate was divided into 12 segmented regions. For tumor localization, each prostate was divided into halves: right and left. Each half was further divided into 6 regions as follows: (A) outside peripheral zone (Pz) anterior, (B) outside Pz posterior, (C) inside Pz, (D) central transitional zone (Tz), (E) Tz anterior, (F) apex.

Mentions: For tumor localization, a prostate was divided into halves: right (R) and left (L). Then each half was divided into 6 segments: outside Pz anterior, outside Pz posterior, inside Pz, central Tz, Tz anterior, and apex. Thus, in each case, we had 12 segmental regions of interest (ROIs) within the whole prostate of each patient (Fig. 2). PBx specimens for each segmental region were evaluated for cancer presence. To evaluate the diagnostic performance of each MR sequence (Fig. 2), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of T2W, DWI, 1H-MRS, and PBx were compared between groups by using the Z-test. For this approach, the sensitivity of an imaging modality or PBx result was defined as the probability of correctly identifying a histopathologically proven cancer focus. Specificity was defined as the probability of correctly identifying regions negative for cancer. In addition, we evaluated the combined diagnostic accuracy of multiple imaging variables. We calculated areas under the receiver operator curves (AUCs) of each MR sequence and PBx. An region of Interest study was performed by using Discover JMP ver. 11.0 (SAS Institute Inc., Cary, NC, USA). Variables are expressed as medians with interquartile ranges (IQRs). All P-values corresponded to two-sided tests, with a P-value of 0.05 considered to represent a significant difference.


Feasibility of multiparametric prostate magnetic resonance imaging in the detection of cancer distribution: histopathological correlation with prostatectomy specimens.

Kitamura K, Muto S, Yokota I, Hoshimoto K, Kaminaga T, Noguchi T, Sugiura S, Ide H, Yamaguchi R, Furui S, Horie S - Prostate Int (2014)

Each prostate was divided into 12 segmented regions. For tumor localization, each prostate was divided into halves: right and left. Each half was further divided into 6 regions as follows: (A) outside peripheral zone (Pz) anterior, (B) outside Pz posterior, (C) inside Pz, (D) central transitional zone (Tz), (E) Tz anterior, (F) apex.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4286731&req=5

f2-pi-2-4-188: Each prostate was divided into 12 segmented regions. For tumor localization, each prostate was divided into halves: right and left. Each half was further divided into 6 regions as follows: (A) outside peripheral zone (Pz) anterior, (B) outside Pz posterior, (C) inside Pz, (D) central transitional zone (Tz), (E) Tz anterior, (F) apex.
Mentions: For tumor localization, a prostate was divided into halves: right (R) and left (L). Then each half was divided into 6 segments: outside Pz anterior, outside Pz posterior, inside Pz, central Tz, Tz anterior, and apex. Thus, in each case, we had 12 segmental regions of interest (ROIs) within the whole prostate of each patient (Fig. 2). PBx specimens for each segmental region were evaluated for cancer presence. To evaluate the diagnostic performance of each MR sequence (Fig. 2), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of T2W, DWI, 1H-MRS, and PBx were compared between groups by using the Z-test. For this approach, the sensitivity of an imaging modality or PBx result was defined as the probability of correctly identifying a histopathologically proven cancer focus. Specificity was defined as the probability of correctly identifying regions negative for cancer. In addition, we evaluated the combined diagnostic accuracy of multiple imaging variables. We calculated areas under the receiver operator curves (AUCs) of each MR sequence and PBx. An region of Interest study was performed by using Discover JMP ver. 11.0 (SAS Institute Inc., Cary, NC, USA). Variables are expressed as medians with interquartile ranges (IQRs). All P-values corresponded to two-sided tests, with a P-value of 0.05 considered to represent a significant difference.

Bottom Line: These results were compared with the histopathological findings for RP specimens.The area under the receiver operator characteristic curve analysis yielded a higher value for DWI (0.68) than for T2W (0.65), (1)H-MRS (0.54), or PBx (0.56).In 180 cancerous regions of RP specimens with false-negative PBx results, T2W+DWI had the highest positive rate (53.3%) compared with that of each sequence alone, including T2W (45.6%), DWI (41.1%), and (1)H-MRS (30.0%).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan ; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.

ABSTRACT

Purpose: To prevent overtreatment, it is very important to diagnose the precise distribution and characteristics of all cancer lesions, including small daughter tumors. The purpose of this study was to evaluate the efficacy of T2-weighted magnetic resonance imaging (T2W), diffusion-weighted magnetic resonance imaging (DWI), magnetic resonance spectroscopy ((1)H-MRS), and prostate biopsy (PBx) in the detection of intraprostatic cancer distribution.

Methods: All patients underwent T2W, DWI, (1)H-MRS, and PBx followed by radical prostatectomy (RP). Individual prostates were divided into 12 segmental regions, each of which was examined for the presence or absence of malignancy on the basis of T2W, DWI, (1)H-MRS, and PBx, respectively. These results were compared with the histopathological findings for RP specimens.

Results: We included 54 consecutive patients with biopsy-proven prostate cancer (mean age, 62.7 years; median prostate-specific antigen level, 5.7 ng/mL) in this study. We could detect cancer in 247 of 540 evaluable lesions. The area under the receiver operator characteristic curve analysis yielded a higher value for DWI (0.68) than for T2W (0.65), (1)H-MRS (0.54), or PBx (0.56). In 180 cancerous regions of RP specimens with false-negative PBx results, T2W+DWI had the highest positive rate (53.3%) compared with that of each sequence alone, including T2W (45.6%), DWI (41.1%), and (1)H-MRS (30.0%).

Conclusions: Multiparametric magnetic resonance imaging (T2W, (1)H-MRS, DWI) enables the detection of prostate cancer distribution with reasonable sensitivity and specificity. T2W+DWI was particularly effective in detecting cancer distribution with false-negative PBx results.

No MeSH data available.


Related in: MedlinePlus