Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease (original) (raw)
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Radiation oncology (London, England), 2014
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Prostate Cancer
Aim. The measurement of the volume of the prostate gland can have an influence on many clinical decisions. Various imaging methods have been used to measure it. Our aim was to conduct the first systematic review of their accuracy. Methods. The literature describing the accuracy of imaging methods for measuring the prostate gland volume was systematically reviewed. Articles were included if they compared volume measurements obtained by medical imaging with a reference volume measurement obtained after removal of the gland by radical prostatectomy. Correlation and concordance statistics were summarised. Results. 28 articles describing 7768 patients were identified. The imaging methods were ultrasound, computed tomography, and magnetic resonance imaging (US, CT, and MRI). Wide variations were noted but most articles about US and CT provided correlation coefficients that lay between 0.70 and 0.90, while those describing MRI seemed slightly more accurate at 0.80-0.96. When concordance wa...
BMC Urology
Background Although multiparametric magnetic resonance imaging (mpMRI) is widely used to assess the volume of prostate cancer, it often underestimates the histological tumor boundary. The aim of this study was to evaluate the feasibility of combining prostate health index (PHI) and mpMRI to estimate the histological tumor diameter and determine the safety margin during treatment of prostate cancer. Methods We retrospectively enrolled 72 prostate cancer patients who underwent radical prostatectomy and had received PHI tests and mpMRI before surgery. We compared the discrepancy between histological and radiological tumor diameter stratified by Prostate Imaging-Reporting and Data System (PI-RADS) score, and then assessed the influence of PHI on the discrepancy between low PI-RADS (2 or 3) and high PI-RADS (4 or 5) groups. Results The mean radiological and histological tumor diameters were 1.60 cm and 2.13 cm, respectively. The median discrepancy between radiological and histological tu...
The Journal of urology, 2015
Multi-parametric MRI often under- or over-estimates the pathological cancer volume. The aim of this study was to develop a novel method to estimate prostate cancer volume using MR/US-fusion biopsy-proven cancer core-length. A total of 81 consecutive clinically localized prostate cancer patients with MR/US-fusion targeted biopsy-proven cancer who subsequently underwent radical prostatectomy were retrospectively analyzed. As 7 patients had two MRI-visible lesions, 88 lesions were analyzed. The dimensions and estimated lesion volume of MR-visible lesions were calculated using ADC maps. The modified formula for estimating cancer volume was defined as the formula of vertical stretching the AP-dimension of the MR-based 3D model in which the MR-estimated lesion-AP-dimension was replaced with MR/US-targeted biopsy-proven cancer core-length. Agreement of the pathological cancer volume (PCV) with the MR-estimated-volume (MCV) or the novel modified-volume was assessed using a Bland-Altman plot...
NMR in Biomedicine, 2019
The VERDICT framework for modelling diffusion MRI data aims to relate parameters from a biophysical model to histological features used for tumour grading in prostate cancer. Validation of the VERDICT model is necessary for clinical use. This study compared VERDICT parameters obtained ex vivo with histology in five specimens from radical prostatectomy. A patient‐specific 3D‐printed mould was used to investigate the effects of fixation on VERDICT parameters and to aid registration to histology. A rich diffusion data set was acquired in each ex vivo prostate before and after fixation. At both time points, data were best described by a two‐compartment model: the model assumes that an anisotropic tensor compartment represents the extracellular space and a restricted sphere compartment models the intracellular space. The effect of fixation on model parameters associated with tissue microstructure was small. The patient‐specific mould minimized tissue deformations and co‐localized slices,...
BJU International, 2014
To evaluate the agreement between prostate tumour volume determined using multiparametric magnetic resonance imaging (MRI) and that determined by histological assessment, using detailed software-assisted co-registration. Materials and Methods A total of 37 patients who underwent 3T multiparametric MRI (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC], dynamic contrast-enhanced [DCE] imaging) were included. A radiologist traced the borders of suspicious lesions on T2WI and ADC and assigned a suspicion score of between 2 and 5, while a uropathologist traced the borders of tumours on histopathological photographs. Software was used to co-register MRI and three-dimensional digital reconstructions of radical prostatectomy specimens and to compute imaging and histopathological volumes. Agreement in volumes between MRI and histology was assessed using Bland-Altman plots and stratified by tumour characteristics. Results Among 50 tumours, the mean differences (95% limits of agreement) in MRI relative to histology were −32% (−128 to +65%) on T2WI and −47% (−143 to +49%) on ADC. For all tumour subsets, volume underestimation was more marked on ADC maps (mean difference ranging from −57 to −16%) than on T2WI (mean difference ranging from −45 to +2%). The 95% limits of agreement were wide for all comparisons, with the lower 95% limit ranging between −77 and −143% across assessments. Volume underestimation was more marked for tumours with a Gleason score ≥7 or a MRI suspicion score 4 or 5. Conclusion Volume estimates of prostate cancer using MRI tended to substantially underestimate histopathological volumes, with a wide variability in extent of underestimation across cases. These findings have implications for efforts to use MRI to guide risk assessment.
The Bulletin of Urooncology, 2021
Objective: This study aimed to investigate the correlation between index lesion prostate imaging-reporting and data system (PI-RADS) version-2 score and histopathological outcomes of prostatectomy specimens. Materials and Methods: A total of 78 male patients with prostate cancer (PCa) treated with robot-assisted radical prostatectomy between August 2015 and June 2020 were included in this study. In this cohort, suspicious lesions on multiparametric magnetic resonance imaging (mpMRI) were scored according to PI-RADS version-2 criteria. MpMRI-targeted prostate biopsy was performed for all suspicious lesions with a PI-RADS score of ≥3 followed by systematic prostate biopsy. The relationship between index lesion PI-RADS score and histopathological outcomes of prostatectomy specimens were evaluated statistically. Results: The mean age of the patients was 65.0±7.0 years. The distribution of PI-RADS scores of 3, 4, and 5 of the index lesions were 6 (7.7%), 29 (37.2%), and 43 (55.1%), respectively. Lower tumor volume and tumor volume ratio were observed in patients with a PI-RADS score of 3 when they were compared with patients with PI-RADS scores of 4 and PI-RADS-5 (p<0.001, for each). No significant correlation was found between index lesion PI-RADS score in mpMRI and clinically significant PCa in prostatectomy specimens (r<0.200, p>0.05). However, a significant correlation was observed between index lesion PI-RADS score and extracapsular extension (ECE), as well as seminal vesicle invasion (SVI) and pT stage (r=0.327, p=0.004; r=0.276, p=0.014, r=0.348, p=0.002, respectively). Conclusion: Increased index lesion PI-RADS scores were associated with ECE, SVI, higher tumor volume, tumor volume ratio, and pT stages. Increased index lesion PI-RADS score in mpMRI may be helpful in prediction of locally advanced PCa in prostatectomy specimens.