Value of the capsular enhancement sign on dynamic contrast-enhanced prostate multiparametric MRI for the detection of extracapsular extension

被引:4
作者
Caglic, Iztok [1 ,2 ,3 ,4 ]
Sushentsev, Nikita [2 ,3 ]
Colarieti, Anna [5 ,6 ]
Warren, Anne Y. [1 ,2 ,7 ]
Shah, Nimish [1 ,2 ,8 ]
Lamb, Benjamin W. [1 ,2 ,8 ]
Barrett, Tristan [1 ,2 ,3 ]
机构
[1] Addenbrookes Hosp, CamPARI Prostate Canc Grp, Cambridge, England
[2] Univ Cambridge, Cambridge CB2 0QQ, England
[3] Addenbrookes Hosp, Dept Radiol, Cambridge CB2 0QQ, England
[4] Univ Ljubljana, Fac Med, Ljubljana, Slovenia
[5] IRCCS San Raffaele Sci Inst, Dept Radiol, Milan, Italy
[6] Univ Vita Salute San Raffaele, Milan, Italy
[7] Addenbrookes Hosp, Dept Pathol, Cambridge, England
[8] Addenbrookes Hosp, Dept Urol, Cambridge, England
基金
英国工程与自然科学研究理事会;
关键词
Magnetic resonance imaging; Dynamic contrast enhanced imaging; Prostate cancer; Staging; INFLUENCES BIOCHEMICAL RECURRENCE; DIFFUSION-WEIGHTED MRI; EXTRAPROSTATIC EXTENSION; RADICAL PROSTATECTOMY; CANCER; LENGTH; INVASION; CONTACT;
D O I
10.1016/j.ejrad.2022.110275
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: 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 uroradiologists 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.
引用
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页数:7
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