Defining the incremental value of 3D T2-weighted imaging in the assessment of prostate cancer extracapsular extension.

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cam.issuedOnline2019-03-18
cam.orpheus.successThu Jan 30 10:53:20 GMT 2020 - Embargo updated
dc.contributor.authorCaglic, Iztok
dc.contributor.authorPovalej Brzan, Petra
dc.contributor.authorWarren, Anne Y
dc.contributor.authorBratt, Ola
dc.contributor.authorShah, Nimish
dc.contributor.authorBarrett, Tristan
dc.contributor.orcidWarren, Anne [0000-0002-1170-7867]
dc.contributor.orcidBarrett, Tristan [0000-0002-1180-1474]
dc.date.accessioned2019-01-22T00:31:41Z
dc.date.available2019-01-22T00:31:41Z
dc.date.issued2019-10
dc.description.abstractOBJECTIVES: To assess the added value of 3D T2-weighted imaging (T2WI) over conventional 2D T2WI in diagnosing extracapsular extension (ECE). METHODS: Seventy-five patients undergoing 3-T MRI before radical prostatectomy were included. PI-RADS ≥ 4 lesions were assessed for ECE on 2D T2W images using a 5-point Likert scale (1 = no ECE, 5 = definite ECE) and the length of tumour prostatic capsular contact. A second read using 3D T2W images and reformats evaluated ECE and the maximal 3D capsular contact length and surface. RESULTS: One hundred six lesions were identified at MRI. ECE was confirmed by histology in 54% (57/106) of lesions and 64% (48/75) of patients. Sensitivity and specificity for 3D T2 reads were 75.4% versus 64.9% (p = 0.058), respectively, and 83.7% versus 85.7% (p = 0.705) for 2D T2 reads, respectively. 3D T2W reads showed significantly higher mean subjective Likert scores of 3.7 ± 1.4 versus 3.3 ± 1.4 (p = 0.001) in ECE-positive lesions and lower mean Likert score of 1.5 ± 1 versus 1.6 ± 0.9 (p = 0.27) in ECE-negative lesions compared with 2D T2W reads. 3D contact significantly increased sensitivity from 59.6 to 73.7% (p = 0.03), whilst maintaining the same specificity of 87.8% (p = 1). High-grade group tumours (≥ Gleason 4 + 3) showed significantly higher ECE prevalence than low-grade tumours (88% versus 44%, p < 0.001) and a positive predictive value (PPV) for ECE of 90.9% with ≥ 5 mm of contact versus PPV of 90.4% at ≥ 12.5 mm for lower grade tumours. CONCLUSIONS: 3D T2WI significantly increases sensitivity and confidence in calling ECE. The capsular contact length threshold differed between low- and high-grade cancers. KEY POINTS: • 3D capsular contact length and 3D surface contact significantly increased sensitivity in diagnosing ECE. • 3D T2W reads significantly increased reader confidence in calling ECE. • Thresholds for capsular contact length differed between low-grade and high-grade cancers.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.35645
dc.identifier.eissn1432-1084
dc.identifier.issn0938-7994
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/288329
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1007/s00330-019-06070-6
dc.subject3D imaging
dc.subjectMagnetic resonance imaging
dc.subjectProstate cancer
dc.subjectTumour staging
dc.subjectAdult
dc.subjectAged
dc.subjectExtranodal Extension
dc.subjectHumans
dc.subjectImage Interpretation, Computer-Assisted
dc.subjectImaging, Three-Dimensional
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeoplasm Grading
dc.subjectNeoplasm Invasiveness
dc.subjectNeoplasm Staging
dc.subjectPredictive Value of Tests
dc.subjectProstatectomy
dc.subjectProstatic Neoplasms
dc.subjectSensitivity and Specificity
dc.titleDefining the incremental value of 3D T2-weighted imaging in the assessment of prostate cancer extracapsular extension.
dc.typeArticle
dcterms.dateAccepted2019-01-07
prism.endingPage5497
prism.issueIdentifier10
prism.publicationDate2019
prism.publicationNameEur Radiol
prism.startingPage5488
prism.volume29
rioxxterms.licenseref.startdate2019-10
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1007/s00330-019-06070-6
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