Journal article
Concordance of preoperative prostate endorectal MRI with subsequent prostatectomy specimen in high-risk prostate cancer patients
Urologic oncology, Vol.31(5), pp.601-606
07/2013
DOI: 10.1016/j.urolonc.2011.05.004
PMID: 21665495
Abstract
Endorectal MRI (ER-MRI) may identify areas suspicious for prostate cancer. We evaluated the accuracy of ER-MRI compared with subsequent pathology specimen from prostatectomy.
We reviewed 309 open radical retropubic prostatectomy cases (RRP) from 2003 to 2008 to identify 94 men with a preoperative ER-MRI, which was obtained in patients with high-risk factors suspicious for local extension (Gleason grade ≥ 4+3, PSA ≥ 10 ng/ml, abnormal rectal exam, or extensive biopsy core involvement). Findings of extracapsular extension (ECE), seminal vesicle invasion (SVI), and lymphadenopathy (LAD) on ER-MRI were compared with subsequent findings on pathology specimens.
Ninety-four men underwent preoperative ER-MRI. No tumor was seen on ER-MRI in 9 men (10%). Of 94 ER-MRIs, 4% showed SVI, and 12% had ECE. At prostatectomy, lymph nodes were pathologically positive in 10 men, none of which were enlarged on ER-MRI. RRP was aborted in 3 of these 10 patients due to positive nodes confirmed on frozen section. Comparing ER-MRI results to subsequent prostatectomy specimen the results for accuracy, positive predictive value, negative predictive value, sensitivity, specificity were 70%, 27%, 76%, 14%, 88% for ECE and 93%, 75%, 94%, 38%, 99% for SVI. The accuracy of ECE prediction was 86% in abnormal rectal exam vs. 66% in normal exam (P < 0.05).
Endorectal MRI in the evaluation of high-risk prostate cancer was moderately accurate for SV involvement but inaccurate for ECE and insensitive for metastatic lymph node involvement. The predictive accuracy of ER-MRI improved in patients with an abnormal rectal exam.
Details
- Title: Subtitle
- Concordance of preoperative prostate endorectal MRI with subsequent prostatectomy specimen in high-risk prostate cancer patients
- Creators
- Kenneth G Nepple - Department of Urology, University of Iowa, Iowa City, IA 52242, USAHenry M Rosevear - Department of Urology, University of Iowa, Iowa City, IA 52242, USAAlan H Stolpen - Department of Radiology, University of Iowa, Iowa City, IA 52242, USAJames A Brown - Department of Urology, University of Iowa, Iowa City, IA 52242, USARichard D Williams - Department of Urology, University of Iowa, Iowa City, IA 52242, USA
- Resource Type
- Journal article
- Publication Details
- Urologic oncology, Vol.31(5), pp.601-606
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.urolonc.2011.05.004
- PMID
- 21665495
- ISSN
- 1078-1439
- eISSN
- 1873-2496
- Language
- English
- Date published
- 07/2013
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Urology; Internal Medicine
- Record Identifier
- 9984051508202771
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