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European Radiology
Published in: European Radiology 7/2013

01-07-2013 | Urogenital

Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study

Authors: Flavie Bratan, Emilie Niaf, Christelle Melodelima, Anne Laure Chesnais, Rémi Souchon, Florence Mège-Lechevallier, Marc Colombel, Olivier Rouvière

Published in: European Radiology | Issue 7/2013

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Abstract

Objectives

To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.

Methods

One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n = 71) or 3 T (n = 104), with (n = 58) or without (n = 117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.

Results

Readers identified 192–214/362 cancers, with 130–155 false positives. Detection rates for tumours of <0.5 cc (cm3), 0.5–2 cc and >2 cc were 33–45/155 (21–29 %), 15–19/35 (43–54 %) and 8–9/12 (67–75 %) for Gleason ≤6, 17/27 (63 %), 42–45/51 (82–88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P < 0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P < 0.005) and aggressiveness of tumours (P < 0.00001).

Conclusions

Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.

Key Points

• Prostate cancer volume, Gleason score, architecture and location are MRI predictors of detection.
• Field strength and coils used do not influence the tumour detection rate.
• Multiparametric MRI is accurate for detecting aggressive tumours.
• A subjective suspicion score can stratify the risk of malignancy and tumour aggressiveness.
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Metadata
Title
Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study
Authors
Flavie Bratan
Emilie Niaf
Christelle Melodelima
Anne Laure Chesnais
Rémi Souchon
Florence Mège-Lechevallier
Marc Colombel
Olivier Rouvière
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2795-0

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