Skip to main content
Top
Published in: World Journal of Urology 9/2018

Open Access 01-09-2018 | Original Article

Local staging with multiparametric MRI in daily clinical practice: diagnostic accuracy and evaluation of a radiologic learning curve

Authors: B. H. E. Jansen, F. H. K. Oudshoorn, A. M. Tijans, M. J. Yska, A. P. Lont, E. R. P. Collette, J. A. Nieuwenhuijzen, A. N. Vis

Published in: World Journal of Urology | Issue 9/2018

Login to get access

Abstract

Purpose

To estimate the diagnostic accuracy of multiparametric MRI (mpMRI) for the detection of locally advanced prostate cancer (T-stage 3–4) prior to radical prostatectomy, in a multicenter cohort representing daily clinical practice. In addition, the radiologic learning curve for the detection of locally advanced disease is evaluated.

Methods

Preoperative mpMRI findings of 430 patients (2012–2016) were compared to pathology results following radical prostatectomy. The diagnostic accuracy (sensitivity, specificity, PPV, and NPV) for the detection of locally advanced disease was calculated and compared for all years separately, to evaluate the presence of a radiological learning curve.

Results

Of all 137 patients with locally advanced disease, 62 patients were preoperatively detected with mpMRI [sensitivity 45.3% (95% CI 36.9–53.6%), specificity 75.8% (CI 70.9–80.7%), PPV 46.6% (CI 38.1–55.1%), and NPV 74.7% (CI 69.8–79.7%)]. The diagnostic accuracy did not improve significantly over time (sensitivity p = 0.12; specificity p = 0.57).

Conclusions

In daily clinical practice, the diagnostic accuracy of mpMRI for the detection of locally advanced prostate cancer remains limited. It, therefore, seems questionable whether mpMRI is adequate to guide preoperative decision-making. No significant radiologic learning curve for the detection of locally advance disease was observed.
Literature
3.
go back to reference Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, Fossati N, Gross T, Henry AM, Joniau S, Lam TB, Mason MD, Matveev VB, Moldovan PC, van den Bergh RCN, Van den Broeck T, van der Poel HG, van der Kwast TH, Rouviere O, Schoots IG, Wiegel T, Cornford P (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71(4):618–629CrossRefPubMed Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, Fossati N, Gross T, Henry AM, Joniau S, Lam TB, Mason MD, Matveev VB, Moldovan PC, van den Bergh RCN, Van den Broeck T, van der Poel HG, van der Kwast TH, Rouviere O, Schoots IG, Wiegel T, Cornford P (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71(4):618–629CrossRefPubMed
6.
go back to reference Sokoloff MH, Brendler CB (2001) Indications and contraindications for nerve-sparing radical prostatectomy. Urol Clin North Am 28(3):535–543CrossRefPubMed Sokoloff MH, Brendler CB (2001) Indications and contraindications for nerve-sparing radical prostatectomy. Urol Clin North Am 28(3):535–543CrossRefPubMed
7.
go back to reference Bolla M, Van Tienhoven G, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, Billiet I, Torecilla JL, Pfeffer R, Cutajar CL, Van der Kwast T, Collette L (2010) External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol 11(11):1066–1073. https://doi.org/10.1016/s1470-2045(10)70223-0 CrossRefPubMed Bolla M, Van Tienhoven G, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, Billiet I, Torecilla JL, Pfeffer R, Cutajar CL, Van der Kwast T, Collette L (2010) External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol 11(11):1066–1073. https://​doi.​org/​10.​1016/​s1470-2045(10)70223-0 CrossRefPubMed
8.
go back to reference Donovan J, Hamdy F, Neal D, Peters T, Oliver S, Brindle L, Jewell D, Powell P, Gillatt D, Dedman D, Mills N, Smith M, Noble S, Lane A (2003) Prostate testing for cancer and treatment (ProtecT) feasibility study. Health Technol Assess 7(14):1–88CrossRefPubMed Donovan J, Hamdy F, Neal D, Peters T, Oliver S, Brindle L, Jewell D, Powell P, Gillatt D, Dedman D, Mills N, Smith M, Noble S, Lane A (2003) Prostate testing for cancer and treatment (ProtecT) feasibility study. Health Technol Assess 7(14):1–88CrossRefPubMed
11.
go back to reference Tosoian JJ, Chappidi M, Feng Z, Humphreys EB, Han M, Pavlovich CP, Epstein JI, Partin AW, Trock BJ (2017) Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: partin tables in the contemporary era. BJU Int 119(5):676–683. https://doi.org/10.1111/bju.13573 CrossRefPubMed Tosoian JJ, Chappidi M, Feng Z, Humphreys EB, Han M, Pavlovich CP, Epstein JI, Partin AW, Trock BJ (2017) Prediction of pathological stage based on clinical stage, serum prostate-specific antigen, and biopsy Gleason score: partin tables in the contemporary era. BJU Int 119(5):676–683. https://​doi.​org/​10.​1111/​bju.​13573 CrossRefPubMed
17.
go back to reference Gaziev G, Wadhwa K, Barrett T, Koo BC, Gallagher FA, Serrao E, Frey J, Seidenader J, Carmona L, Warren A, Gnanapragasam V, Doble A, Kastner C (2016) Defining the learning curve for multiparametric magnetic resonance imaging (MRI) of the prostate using MRI-transrectal ultrasonography (TRUS) fusion-guided transperineal prostate biopsies as a validation tool. BJU Int 117(1):80–86. https://doi.org/10.1111/bju.12892 CrossRefPubMed Gaziev G, Wadhwa K, Barrett T, Koo BC, Gallagher FA, Serrao E, Frey J, Seidenader J, Carmona L, Warren A, Gnanapragasam V, Doble A, Kastner C (2016) Defining the learning curve for multiparametric magnetic resonance imaging (MRI) of the prostate using MRI-transrectal ultrasonography (TRUS) fusion-guided transperineal prostate biopsies as a validation tool. BJU Int 117(1):80–86. https://​doi.​org/​10.​1111/​bju.​12892 CrossRefPubMed
18.
go back to reference Latchamsetty KC, Borden LS Jr, Porter CR, Lacrampe M, Vaughan M, Lin E, Conti N, Wright JL, Corman JM (2007) Experience improves staging accuracy of endorectal magnetic resonance imaging in prostate cancer: what is the learning curve? Can J Urol 14(1):3429–3434PubMed Latchamsetty KC, Borden LS Jr, Porter CR, Lacrampe M, Vaughan M, Lin E, Conti N, Wright JL, Corman JM (2007) Experience improves staging accuracy of endorectal magnetic resonance imaging in prostate cancer: what is the learning curve? Can J Urol 14(1):3429–3434PubMed
Metadata
Title
Local staging with multiparametric MRI in daily clinical practice: diagnostic accuracy and evaluation of a radiologic learning curve
Authors
B. H. E. Jansen
F. H. K. Oudshoorn
A. M. Tijans
M. J. Yska
A. P. Lont
E. R. P. Collette
J. A. Nieuwenhuijzen
A. N. Vis
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 9/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2295-6

Other articles of this Issue 9/2018

World Journal of Urology 9/2018 Go to the issue