Prostate cancer

Accurate determination of extracapsular extension with high-spatial-resolution dynamic contrast-enhanced and T2-weighted MR imaging - Initial results

B. Nicolas Bloch, Edna Furman-Haran, Thomas H. Helbich, Robert E. Lenkinski, Hadassa Degani, Christian Kratzik, Martin Susani, Andrea Haitel, Silvia Jaromi, Long Ngo, Neil M. Rofsky

Research output: Contribution to journalArticle

190 Citations (Scopus)

Abstract

Purpose: To prospectively compare the sensitivity and specificity of high-spatial-resolution dynamic contrast material-enhanced magnetic resonance (MR) imaging with those of high-spatial-resolution T2-weighted MR imaging, performed with an endorectal coil (ERC), for assessment of extracapsular extension (ECE) and staging in patients with prostate cancer, with histopathologic findings as reference. Materials and Methods: The study was approved by the institutional internal review board; a signed informed consent was obtained. MR imaging of the prostate at 1.5 T was performed with combined surface coils and ERCs in 32 patients (mean age, 65 years; range, 42-78 years) before radical prostatectomy. High-spatial-resolution T2-weighted fast spin-echo and high-spatial-resolution dynamic contrast-enhanced three-dimensional gradient-echo images were acquired with gadopentetate dimeglumine. Dynamic contrast-enhanced MR images were analyzed with a computer-generated color-coded scheme. Two experienced readers independently assessed EGE and tumor stage. MR imaging-based staging results were compared with histopathologic results. For the prediction of ECE, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Staging accuracy was determined with the area under the receiver operating characteristic curve (AUC) by using the Wilcoxon-Mann-Whitney index of diagnostic accuracy. Results: The mean sensitivity, specificity, PPV, and NPV for assessment of ECE with the combined data sets for both readers were 86%, 95%, 90%, and 93%, respectively. The sensitivity of MR images for determination of ECE was significantly improved for both readers (>25%) with combined data sets compared with T2-weighted MR images alone. The combined data sets had a mean overall staging accuracy for both readers of 95%, as determined with AUC. Staging results for both readers were significantly improved (P < .05) with the combined data sets compared with T2-weighted MR images alone. Conclusion: The combination of high-spatial-resolution dynamic contrast-enhanced MR imaging and T2-weighted MR imaging yields improved assessment of ECE and better results for prostate cancer staging compared with either technique independently.

Original languageEnglish (US)
Pages (from-to)176-185
Number of pages10
JournalRadiology
Volume245
Issue number1
DOIs
StatePublished - Oct 2007

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Prostatic Neoplasms
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Sensitivity and Specificity
Area Under Curve
Gadolinium DTPA
Neoplasm Staging
Research Ethics Committees
Prostatectomy
Informed Consent
ROC Curve
Contrast Media
Prostate
Color
Datasets
Neoplasms

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Prostate cancer : Accurate determination of extracapsular extension with high-spatial-resolution dynamic contrast-enhanced and T2-weighted MR imaging - Initial results. / Bloch, B. Nicolas; Furman-Haran, Edna; Helbich, Thomas H.; Lenkinski, Robert E.; Degani, Hadassa; Kratzik, Christian; Susani, Martin; Haitel, Andrea; Jaromi, Silvia; Ngo, Long; Rofsky, Neil M.

In: Radiology, Vol. 245, No. 1, 10.2007, p. 176-185.

Research output: Contribution to journalArticle

Bloch, B. Nicolas ; Furman-Haran, Edna ; Helbich, Thomas H. ; Lenkinski, Robert E. ; Degani, Hadassa ; Kratzik, Christian ; Susani, Martin ; Haitel, Andrea ; Jaromi, Silvia ; Ngo, Long ; Rofsky, Neil M. / Prostate cancer : Accurate determination of extracapsular extension with high-spatial-resolution dynamic contrast-enhanced and T2-weighted MR imaging - Initial results. In: Radiology. 2007 ; Vol. 245, No. 1. pp. 176-185.
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abstract = "Purpose: To prospectively compare the sensitivity and specificity of high-spatial-resolution dynamic contrast material-enhanced magnetic resonance (MR) imaging with those of high-spatial-resolution T2-weighted MR imaging, performed with an endorectal coil (ERC), for assessment of extracapsular extension (ECE) and staging in patients with prostate cancer, with histopathologic findings as reference. Materials and Methods: The study was approved by the institutional internal review board; a signed informed consent was obtained. MR imaging of the prostate at 1.5 T was performed with combined surface coils and ERCs in 32 patients (mean age, 65 years; range, 42-78 years) before radical prostatectomy. High-spatial-resolution T2-weighted fast spin-echo and high-spatial-resolution dynamic contrast-enhanced three-dimensional gradient-echo images were acquired with gadopentetate dimeglumine. Dynamic contrast-enhanced MR images were analyzed with a computer-generated color-coded scheme. Two experienced readers independently assessed EGE and tumor stage. MR imaging-based staging results were compared with histopathologic results. For the prediction of ECE, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Staging accuracy was determined with the area under the receiver operating characteristic curve (AUC) by using the Wilcoxon-Mann-Whitney index of diagnostic accuracy. Results: The mean sensitivity, specificity, PPV, and NPV for assessment of ECE with the combined data sets for both readers were 86{\%}, 95{\%}, 90{\%}, and 93{\%}, respectively. The sensitivity of MR images for determination of ECE was significantly improved for both readers (>25{\%}) with combined data sets compared with T2-weighted MR images alone. The combined data sets had a mean overall staging accuracy for both readers of 95{\%}, as determined with AUC. Staging results for both readers were significantly improved (P < .05) with the combined data sets compared with T2-weighted MR images alone. Conclusion: The combination of high-spatial-resolution dynamic contrast-enhanced MR imaging and T2-weighted MR imaging yields improved assessment of ECE and better results for prostate cancer staging compared with either technique independently.",
author = "Bloch, {B. Nicolas} and Edna Furman-Haran and Helbich, {Thomas H.} and Lenkinski, {Robert E.} and Hadassa Degani and Christian Kratzik and Martin Susani and Andrea Haitel and Silvia Jaromi and Long Ngo and Rofsky, {Neil M.}",
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T2 - Accurate determination of extracapsular extension with high-spatial-resolution dynamic contrast-enhanced and T2-weighted MR imaging - Initial results

AU - Bloch, B. Nicolas

AU - Furman-Haran, Edna

AU - Helbich, Thomas H.

AU - Lenkinski, Robert E.

AU - Degani, Hadassa

AU - Kratzik, Christian

AU - Susani, Martin

AU - Haitel, Andrea

AU - Jaromi, Silvia

AU - Ngo, Long

AU - Rofsky, Neil M.

PY - 2007/10

Y1 - 2007/10

N2 - Purpose: To prospectively compare the sensitivity and specificity of high-spatial-resolution dynamic contrast material-enhanced magnetic resonance (MR) imaging with those of high-spatial-resolution T2-weighted MR imaging, performed with an endorectal coil (ERC), for assessment of extracapsular extension (ECE) and staging in patients with prostate cancer, with histopathologic findings as reference. Materials and Methods: The study was approved by the institutional internal review board; a signed informed consent was obtained. MR imaging of the prostate at 1.5 T was performed with combined surface coils and ERCs in 32 patients (mean age, 65 years; range, 42-78 years) before radical prostatectomy. High-spatial-resolution T2-weighted fast spin-echo and high-spatial-resolution dynamic contrast-enhanced three-dimensional gradient-echo images were acquired with gadopentetate dimeglumine. Dynamic contrast-enhanced MR images were analyzed with a computer-generated color-coded scheme. Two experienced readers independently assessed EGE and tumor stage. MR imaging-based staging results were compared with histopathologic results. For the prediction of ECE, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Staging accuracy was determined with the area under the receiver operating characteristic curve (AUC) by using the Wilcoxon-Mann-Whitney index of diagnostic accuracy. Results: The mean sensitivity, specificity, PPV, and NPV for assessment of ECE with the combined data sets for both readers were 86%, 95%, 90%, and 93%, respectively. The sensitivity of MR images for determination of ECE was significantly improved for both readers (>25%) with combined data sets compared with T2-weighted MR images alone. The combined data sets had a mean overall staging accuracy for both readers of 95%, as determined with AUC. Staging results for both readers were significantly improved (P < .05) with the combined data sets compared with T2-weighted MR images alone. Conclusion: The combination of high-spatial-resolution dynamic contrast-enhanced MR imaging and T2-weighted MR imaging yields improved assessment of ECE and better results for prostate cancer staging compared with either technique independently.

AB - Purpose: To prospectively compare the sensitivity and specificity of high-spatial-resolution dynamic contrast material-enhanced magnetic resonance (MR) imaging with those of high-spatial-resolution T2-weighted MR imaging, performed with an endorectal coil (ERC), for assessment of extracapsular extension (ECE) and staging in patients with prostate cancer, with histopathologic findings as reference. Materials and Methods: The study was approved by the institutional internal review board; a signed informed consent was obtained. MR imaging of the prostate at 1.5 T was performed with combined surface coils and ERCs in 32 patients (mean age, 65 years; range, 42-78 years) before radical prostatectomy. High-spatial-resolution T2-weighted fast spin-echo and high-spatial-resolution dynamic contrast-enhanced three-dimensional gradient-echo images were acquired with gadopentetate dimeglumine. Dynamic contrast-enhanced MR images were analyzed with a computer-generated color-coded scheme. Two experienced readers independently assessed EGE and tumor stage. MR imaging-based staging results were compared with histopathologic results. For the prediction of ECE, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Staging accuracy was determined with the area under the receiver operating characteristic curve (AUC) by using the Wilcoxon-Mann-Whitney index of diagnostic accuracy. Results: The mean sensitivity, specificity, PPV, and NPV for assessment of ECE with the combined data sets for both readers were 86%, 95%, 90%, and 93%, respectively. The sensitivity of MR images for determination of ECE was significantly improved for both readers (>25%) with combined data sets compared with T2-weighted MR images alone. The combined data sets had a mean overall staging accuracy for both readers of 95%, as determined with AUC. Staging results for both readers were significantly improved (P < .05) with the combined data sets compared with T2-weighted MR images alone. Conclusion: The combination of high-spatial-resolution dynamic contrast-enhanced MR imaging and T2-weighted MR imaging yields improved assessment of ECE and better results for prostate cancer staging compared with either technique independently.

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