Use of multiparametric magnetic resonance imaging in t-staging of prostate cancer: a multicenter study
DOI: https://dx.doi.org/10.18565/urology.2018.4.106-112
I.I. Abdullin, F.A. Kossov, B.Sh. Kamolov, V.V. Kapustin, N.A. Grigor’ev, I.L. Gubskii, V.A. Chernyaev, V.O. Panov, Yu.V. Buidenok, V.B. Matveev
1 European Medical Center, Moscow, Russia; 2 Russian Medical Academy of Continuing Postgraduate Education of Minzdrav of Russia, Moscow, Russia; 3 N.N. Blokhin Russian Cancer Research Scientific Center of Minzdrav of Russia, Moscow, Russia; 4 Moscow State Cancer Hospital No. 62 of the Moscow City Health Department, Moscow Region, Russia; 5 N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia, Moscow, Russia
Aim. The study aimed to analyze the diagnostic performance of preoperative multiparametric magnetic resonance imaging (mp-MRI) in the staging of prostate cancer (PCa) versus postoperative histological examination and determine the most sensitive pulse sequence from the mp-MRI protocol in estimating the local extent of PCa.
Materials and methods. The study comprised 112 men aged 52 to 84 years with a morphologically verified diagnosis of prostate cancer. All patients underwent pelvic mp-MRI before radical prostatectomy (RPE) no earlier than six weeks after the prostate biopsy. Radical prostatectomy was performed within two weeks after mp-MRI. MP-MRI findings and the results of postoperative histology were compared using a binary logistic regression model.
Results. The sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative (NPV) predictive values for predicting extracapsular extension were 87.5, 92.6, 91, 84 and 94.3%, respectively; for predicting seminal vesicles invasion, they were 85, 95, 90, 80.9 and 96.7%, respectively. When stratified by the presence or absence of the pseudocapsule invasion, the reliability of detecting the tumor spread for different types of images decreases in the following order: DWI - T2 + DWI - T2 VI - DCE-MRI.
Conclusion. mp-MRI has high sensitivity, specificity, general diagnostic accuracy, high NPV, and PPV values in detecting an extracapsular extension of prostate cancer. According to the binary logistic regression model, the greatest contribution to the decision on the presence or absence of extracapsular extension is also made by the DWI.
About the Autors
Corresponding author: I. I. Abdullin– Ph.D., Urologist, Head of the Center for the Treatment of Prostate Diseases, Urological Clinic of the European Medical Center, Moscow, Russia; e-mail: iskander.abdullin@gmail.com
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