Document Detail


Prostate cancer: value of multiparametric MR imaging at 3 T for detection--histopathologic correlation.
MedLine Citation:
PMID:  20308447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine utility of multiparametric imaging performed at 3 T for detection of prostate cancer by using T2-weighted magnetic resonance (MR) imaging, MR spectroscopy, and dynamic contrast material-enhanced MR imaging, with whole-mount pathologic findings as reference standard.
MATERIALS AND METHODS: This prospectively designed, HIPAA-compliant, single-institution study was approved by the local institutional review board. Seventy consecutive patients (mean age, 60.4 years; mean prostate-specific antigen level, 5.47 ng/mL [5.47 microg/L]; range, 1-19.9 ng/mL [1-19.9 microg/L]) were included; informed consent was obtained from each patient. All patients had biopsy-proved prostate cancer, with a median Gleason score of 7 (range, 6-9). Images were obtained by using a combination of six-channel cardiac and endorectal coils. MR imaging and pathologic findings were evaluated independently and blinded and then correlated with histopathologic findings by using side-by-side comparison. Analyses were conducted with a raw stringent approach and an alternative neighboring method, which accounted for surgical deformation, shrinkage, and nonuniform slicing factors in pathologic specimens. Generalized estimating equations (GEEs) were used to estimate the predictive value of region-specific, pathologically determined cancer for all three modalities. This approach accounts for the correlation among multiple regions in the same individual.
RESULTS: For T2-weighted MR imaging, sensitivity and specificity values obtained with stringent approach were 0.42 (95% confidence interval [CI]: 0.36, 0.47) and 0.83 (95% CI: 0.81, 0.86), and for the alternative neighboring approach, sensitivity and specificity values were 0.73 (95% CI: 0.67, 0.78) and 0.89 (95% CI: 0.85, 0.93), respectively. The combined diagnostic accuracy of T2-weighted MR imaging, dynamic contrast-enhanced MR imaging, and MR spectroscopy for peripheral zone tumors was examined by calculating their predictive value with different combinations of techniques; T2-weighted MR imaging, dynamic contrast-enhanced MR imaging, and MR spectroscopy provided significant independent and additive predictive value when GEEs were used (P < .001, P = .02, P = .002, respectively).
CONCLUSION: Multiparametric MR imaging (T2-weighted MR imaging, MR spectroscopy, dynamic contrast-enhanced MR imaging) of the prostate at 3 T enables tumor detection, with reasonable sensitivity and specificity values.
Authors:
Baris Turkbey; Peter A Pinto; Haresh Mani; Marcelino Bernardo; Yuxi Pang; Yolanda L McKinney; Kiranpreet Khurana; Gregory C Ravizzini; Paul S Albert; Maria J Merino; Peter L Choyke
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Radiology     Volume:  255     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-05-06     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-99     Citation Subset:  AIM; IM    
Copyright Information:
RSNA, 2010
Affiliation:
Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182, Bldg 10, Room 1B40, Bethesda, MD 20892-1088, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biopsy
Confidence Intervals
Contrast Media
Gadolinium DTPA / diagnostic use
Humans
Image Interpretation, Computer-Assisted / methods
Magnetic Resonance Imaging / methods*
Magnetic Resonance Spectroscopy / methods
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Prostatectomy
Prostatic Neoplasms / diagnosis*,  pathology,  surgery
Sensitivity and Specificity
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA
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