| Endorectal MRI after radiation therapy: questioning the sextant analysis. | |
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MedLine Citation:
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PMID: 21509865 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate whether the information gained by three coregistration systems (sextant, hemi-prostate, and whole gland) differs significantly, suggesting that one approach should be routinely favored over the others. Despite its known limitations, sextant is the generally accepted standard for magnetic resonance imaging (MRI) and biopsy coregistration; nevertheless, depending on the magnitude of localization errors, other options may be adequate. MATERIALS AND METHODS: Institutional Review Board approval was obtained and the study was Health Insurance Portability and Accountability Act (HIPAA)-compliant. We identified 70 patients who underwent 1.5 T endorectal MRI of the prostate between 1999 and 2008 after external beam radiotherapy for prostate cancer. A single reader reviewed all T2-weighted images for the presence or absence of tumor. The performance of each approach was quantified using receiver operating characteristic (ROC) curve analysis. Transrectal ultrasound-guided sextant biopsies were used as a standard of reference. RESULTS: The areas under the ROC curve indicating accuracy for each MRI approach were 0.63 (sextant), 0.68 (hemi-prostate), and 0.71 (whole gland). There was no statistically significant difference among these approaches. CONCLUSION: As expected, the point estimate was higher for the whole-gland approach, but not significantly. Reliable assessment of locally recurrent prostate cancer after external beam radiotherapy by endorectal MRI may be made using a sextant, hemi-prostate, or whole gland approach. The option for one or another approach should not be solely based on estimations of imaging accuracy, but on the purpose of the procedure. |
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Authors:
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Shilpa R Kumbhani; Fergus V Coakley; Charles E McCulloch; Z Jane Wang; John Kurhanewicz; Mack Roach; Antonio C Westphalen |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of magnetic resonance imaging : JMRI Volume: 33 ISSN: 1522-2586 ISO Abbreviation: J Magn Reson Imaging Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-21 Completed Date: 2011-10-03 Revised Date: 2012-05-02 |
Medline Journal Info:
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Nlm Unique ID: 9105850 Medline TA: J Magn Reson Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 1086-90 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Wiley-Liss, Inc. |
Affiliation:
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Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California 94143-0628, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Humans Magnetic Resonance Imaging / methods* Male Middle Aged Prostate / pathology, radiation effects* Prostatic Neoplasms / complications, radiotherapy* ROC Curve Radiation Injuries Rectum / pathology, radiation effects* Recurrence Reproducibility of Results Retrospective Studies |
| Grant Support | |
ID/Acronym/Agency:
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KL2 RR024130/RR/NCRR NIH HHS; KL2 RR024130-03/RR/NCRR NIH HHS |
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