| Clinically low-risk prostate cancer: evaluation with transrectal doppler ultrasound and functional magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 21437432 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate transrectal ultrasound, amplitude Doppler ultrasound, conventional T2-weighted magnetic resonance imaging, spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in localizing and locally staging low-risk prostate cancer. INTRODUCTION: Prostate cancer has been diagnosed at earlier stages and the most accepted classification for low-risk prostate cancer is based on clinical stage T1c or T2a, Gleason score <6, and prostate-specific antigen (PSA) <10 ng/ml. METHODS: From 2005 to 2006, magnetic resonance imaging was performed in 42 patients, and transrectal ultrasound in 26 of these patients. Seven patients were excluded from the study. Mean patient age was 64.94 years and mean serum PSA was 6.05 ng/ml. The examinations were analyzed for tumor identification and location in prostate sextants, detection of extracapsular extension, and seminal vesicle invasion, using surgical pathology findings as the gold standard. RESULTS: Sixteen patients (45.7%) had pathologically proven organ-confined disease, 11 (31.4%) had positive surgical margin, 8 (28.9%) had extracapsular extension, and 3 (8.6%) presented with extracapsular extension and seminal vesicle invasion. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy values for localizing low-risk prostate cancer were 53.1%, 48.3%, 63.4%, 37.8% and 51.3% for transrectal ultrasound; 70.4%, 36.2%, 65.1%, 42.0% and 57.7% for amplitude Doppler ultrasound; 71.5%, 58.9%, 76.6%, 52.4% and 67.1% for magnetic resonance imaging; 70.4%, 58.7%, 78.4%, 48.2% and 66.7% for magnetic resonance spectroscopy; 67.2%, 65.7%, 79.3%, 50.6% and 66.7% for dynamic contrast-enhanced magnetic resonance imaging, respectively. Sensitivity, specificity, PPV, NPV and accuracy values for detecting extracapsular extension were 33.3%, 92%, 14.3%, 97.2% and 89.7% for transrectal ultrasound and 50.0%, 77.6%, 13.7%, 95.6% and 75.7% for magnetic resonance imaging, respectively. For detecting seminal vesicle invasion, these values were 66.7%, 85.7%, 22.2%, 97.7% and 84.6% for transrectal ultrasound and 40.0%, 83.1%, 15.4%, 94.7% and 80.0% for magnetic resonance imaging. CONCLUSION: Although preliminary, our results suggest that imaging modalities have limited usefulness in localizing and locally staging clinically low-risk prostate cancer. |
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Authors:
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Maria Inês Novis; Ronaldo Hueb Baroni; Luciana Mendes de Oliveira Cerri; Romulo Loss Mattedi; Carlos Alberto Buchpiguel |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinics (São Paulo, Brazil) Volume: 66 ISSN: 1980-5322 ISO Abbreviation: Clinics (Sao Paulo) Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101244734 Medline TA: Clinics (Sao Paulo) Country: Brazil |
Other Details:
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Languages: eng Pagination: 27-34 Citation Subset: IM |
Affiliation:
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Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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