Document Detail

Normal central zone of the prostate and central zone involvement by prostate cancer: clinical and MR imaging implications.
MedLine Citation:
PMID:  22357889     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the anatomic features of the central zone of the prostate on T2-weighted and diffusion-weighted (DW) magnetic resonance (MR) images and evaluate the diagnostic performance of MR imaging in detection of central zone involvement by prostate cancer.
MATERIALS AND METHODS: The institutional review board waived informed consent and approved this retrospective, HIPAA-compliant study of 211 patients who underwent T2-weighted and DW MR imaging of the prostate before radical prostatectomy. Whole-mount step-section pathologic findings were the reference standard. Two radiologists independently recorded the visibility, MR signal intensity, size, and symmetry of the central zone and scored the likelihood of central zone involvement by cancer on T2-weighted MR images and on T2-weighted MR images plus apparent diffusion coefficient (ADC) maps generated from the DW MR images. Descriptive summary statistics were calculated for central zone imaging features. Sensitivity, specificity, and area under the curve were used to evaluate reader performance in detecting central zone involvement.
RESULTS: For readers 1 and 2, the central zone was visible, at least partially, in 177 (84%) and 170 (81%) of 211 patients, respectively. The most common imaging appearance of the central zone was symmetric, homogeneous low signal intensity. Cancers involving the central zone had higher prostate-specific antigen values, Gleason scores, and rates of extracapsular extension and seminal vesicle invasion compared with cancers not involving the central zone (P < .05). Area under the curve, sensitivity, and specificity in detecting central zone involvement were 0.70, 0.30, and 0.96 for reader 1 and 0.65, 0.35, and 0.93 for reader 2, and these values did not differ significantly between T2-weighted imaging and T2-weighted imaging plus ADC maps.
CONCLUSION: The central zone was visualized in most patients. Cancers involving the central zone were associated with more aggressive disease than those without central zone involvement.
Hebert Alberto Vargas; Oguz Akin; Tobias Franiel; Debra A Goldman; Kazuma Udo; Karim A Touijer; Victor E Reuter; Hedvig Hricak
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Radiology     Volume:  262     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-23     Completed Date:  2012-04-27     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  894-902     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2012.
Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C-278, New York, NY 10065, USA.
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MeSH Terms
Aged, 80 and over
Area Under Curve
Magnetic Resonance Imaging / methods*
Middle Aged
Prostate / anatomy & histology*
Prostatic Neoplasms / pathology*,  surgery
Retrospective Studies
Sensitivity and Specificity
Statistics, Nonparametric
Grant Support
Erratum In:
Radiology. 2012 Aug;264(2):617

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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