Aims and objectives
In prostate cancer with extraprostatic extension,
patients are at increased risk of recurrence and metastatic disease.
the distinction between organ-confined disease and extraprostatic disease is crucial for disease management.
Multiparametric prostate MRI (mpMRI) is used to determine tumor extent.
MRI has poor sensitivity for local prostate cancer staging .
Some preoperative clinical variables may be predictive of tumor stage in prostate cancer [2,3]. The purpose of...
Methods and materials
The local institutional review board approved this retrospective study.
The study population was drawn from 1184 consecutive patients who underwent mpMRI between January 2015 and September 2017.
A total of 69 patients who underwent radical prostatectomy for clinically localized or locally advanced prostate cancer were enrolled in this single-center study.
No patient had a prior therapy for prostate cancer.
All mpMRI examinations were performed with a 1.5 T MRI system (Ingenia,
Table 1 shows patient characteristics.
Histopathological workup revealed prostate cancer with ECE in 22 (32%) patients (13 patients with Gleason score 7,
and 9 patients with Gleason score ≥8).
Figures show mpMRI images of cases with ECE (Figure 1 and 2) and without ECE (Figure 3).
The accuracy of mpMRI was 81%,
with sensitivity of 86% and specificity of 79% for detection of ECE (Table 2).
The negative and positive predictive values were 93% and 66%,
ECE rate was 91%,
In the PI-RADS v2 document,
MRI is useful for distinguishing ≥T3 disease (extending beyond the gland) from ≤T2 disease (confined to the gland) .
In this study,
we found that mp-MRI with PI-RADS v2 has an accuracy of 81%,
with sensitivity of 86%,
specificity of 79%,
negative predictive value of 93%,
positive predictive value of 66%,
for determining presence of ECE.
De Rooij et al.
 performed a meta-analysis with a large number of studies and concluded that MRI has high specificity (91%)...
de Rooij M,
AccuracyofMagnetic Resonance ImagingforLocalStagingofProstate Cancer: A Diagnostic Meta-analysis.
doi: 10.1016/j.eururo.2015.07.029. 2.
Prostate specific antigen density correlates with features of prostate cancer aggressiveness.J Urol2007; 177: 505–9.
doi: 10.1016/j.juro.2006.09.039. 3.
Ohadian Moghadam S,
Prostate-Specific Antigen Density...