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Extraprostatic Tumor Extension: Comparison of Preoperative Multiparametric MRI Criteria and Histopathologic Correlation after Radical Prostatectomy
- Source :
- Radiology. 296(1)
- Publication Year :
- 2020
-
Abstract
- Background There are no standardized and well-validated criteria for assessing the risk of extraprostatic extension (EPE) of prostate cancer at preoperative multiparametric MRI. Purpose To compare diagnostic performance, intra- and interreader agreement, and correlations of MRI-based criteria for assessment of EPE after radical prostatectomy, including EPE grade, European Society of Urogenital Radiology (ESUR) score, Likert scale, and capsular contact length (CCL). Materials and Methods This retrospective study included consecutive men who underwent MRI and radical prostatectomy between July 2016 and March 2017. Two genitourinary radiologists independently estimated the probability of EPE by using four MRI-based scoring methods. The diagnostic accuracies and intra- and interobserver agreement were evaluated with area under the receiver operating characteristic curve (AUC) and κ statistics, respectively. Correlations between MRI-based score and histologic extent of EPE were analyzed by using the Spearman correlation coefficient (ρ). Results A total of 301 men (mean age ± standard deviation, 65 years ± 7) were evaluated. A total of 129 (42.9%) men had EPE. The AUC ranges of EPE grade, ESUR score, Likert scale, and CCL for assessment of EPE were 0.77-0.81, 0.79-0.81, 0.78-0.79, and 0.78-0.85, respectively, for the two readers. The Likert scale showed lower sensitivity (68.2% [88 of 129] for reader 1, 72.1% [93 of 129] for reader 2) than did EPE grade (77.5% [100 of 129] for reader 1, 79.8% [103 of 129] for reader 2; P ≤ .04). Intra- and interreader agreement were substantial (κ range, 0.61-0.74) for the four methods, with ESUR score showing the lowest values (κ = 0.61 and κ = 0.63, respectively). EPE grade showed highest correlation with histologic extent of EPE (ρ = 0.53 and ρ = 0.55 for circumferential length; ρ = 0.42 and ρ = 0.55 for radial length for readers 1 and 2, respectively; P < .001). Conclusion Extraprostatic extension (EPE) grade, European Society of Urogenital Radiology score, Likert scale, and capsular contact length showed good overall diagnostic performance; however, the EPE grade resulted in more reliable performance and had the highest correlation with histologic EPE extent. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Padhani and Petralia in this issue.
- Subjects :
- Male
medicine.medical_treatment
Spearman's rank correlation coefficient
030218 nuclear medicine & medical imaging
Correlation
03 medical and health sciences
0302 clinical medicine
Preoperative Care
medicine
Humans
Radiology, Nuclear Medicine and imaging
Multiparametric Magnetic Resonance Imaging
Aged
Retrospective Studies
Prostatectomy
Receiver operating characteristic
business.industry
Scoring methods
Prostate
Multiparametric MRI
Prostatic Neoplasms
Extraprostatic
030220 oncology & carcinogenesis
Prostate surgery
business
Nuclear medicine
Subjects
Details
- ISSN :
- 15271315
- Volume :
- 296
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Radiology
- Accession number :
- edsair.doi.dedup.....3ecb6053dc91bb160bd9dc9ae3dbfa99