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dc.contributor.authorCaglic, Iztok
dc.contributor.authorSushentsev, Nikita
dc.contributor.authorColarieti, Anna
dc.contributor.authorWarren, Anne Y
dc.contributor.authorShah, Nimish
dc.contributor.authorLamb, Benjamin W
dc.contributor.authorBarrett, Tristan
dc.description.abstractPURPOSE: To retrospectively determine the prevalence and diagnostic performance of the capsular enhancement sign (CES) on multiparametric (mp) MRI for the detection of prostate cancer (PCa) extracapsular extension (ECE). METHODS: This retrospective study included patients who underwent mpMRI prior to radical prostatectomy. CES was defined as an area of asymmetrical early hyperenhancement on DCE-MRI adjacent to a peripheral zone tumour, matched or exceeded the tumour circumferential diameter, and with persistent enhancement. Two uro-radiologists evaluated the presence of CES on mpMRI, independently and in consensus, with interobserver agreement calculated using bias and prevalence-adjusted kappa (PABAK). CES performance for predicting ECE was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: The study included 146 patients, with 91/146 (62%) having ECE on surgical pathology. Following initial review, Reader 1 identified 12/146 (8%) CES-positive cases, while Reader 2 reported 14/146 (10%) CES-positive cases, with 15/146 (10%) lesions determined as demonstrating the CES sign on consensus reading. PABAK for CES between the two readers was high at 0.90. All consensus determined CES-positive lesions represented pathological stage ≥ T3a disease, with the overall prevalence of CES among tumours with confirmed ECE being 15/91 (17%). The sign showed high specificity (100%) and PPV (100%) for ECE detection, but with low sensitivity, NPV, and accuracy at 16.5%, 41.3%, and 47.4%, respectively. CONCLUSIONS: CES was demonstrated to be a rare but highly specific ECE predictor on mpMRI that may improve local staging in the patients in whom it is demonstrated.
dc.description.sponsorshipThe authors acknowledge support from National Institute of Health Research Cambridge Biomedical Research Centre, Cancer Research UK (Cambridge Imaging Centre grant number C197/A16465), the Engineering and Physical Sciences Research Council Imaging Centre in Cambridge and Manchester and the Cambridge Experimental Cancer Medicine Centre.
dc.publisherElsevier BV
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.subjectDynamic contrast enhanced imaging
dc.subjectMagnetic resonance imaging
dc.subjectProstate cancer
dc.subjectExtranodal Extension
dc.subjectMagnetic Resonance Imaging
dc.subjectMultiparametric Magnetic Resonance Imaging
dc.subjectNeoplasm Staging
dc.subjectProstatic Neoplasms
dc.subjectRetrospective Studies
dc.titleValue of the capsular enhancement sign on dynamic contrast-enhanced prostate multiparametric MRI for the detection of extracapsular extension.
dc.publisher.departmentDepartment of Radiology Student
prism.publicationNameEur J Radiol
dc.contributor.orcidWarren, Anne [0000-0002-1170-7867]
dc.contributor.orcidBarrett, Tristan [0000-0002-1180-1474]
rioxxterms.typeJournal Article/Review
pubs.funder-project-idNational Institute for Health Research (IS-BRC-1215-20014)
cam.orpheus.successTue Apr 12 08:22:49 BST 2022 - Embargo updated
pubs.licence-display-nameApollo Repository Deposit Licence Agreement

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Attribution-NonCommercial-NoDerivatives 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial-NoDerivatives 4.0 International