1625 WHAT IS THE ADDED VALUE OF ROUTINE PELVIC MRI IN PROSTATE CANCER EVALUATION IN DAILY PRACTICE? A 10- YEARS EXPERIENCE FROM A LARGE PROSTATE CANCER REFERENCE CENTER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VIII1 Apr 20121625 WHAT IS THE ADDED VALUE OF ROUTINE PELVIC MRI IN PROSTATE CANCER EVALUATION IN DAILY PRACTICE? A 10- YEARS EXPERIENCE FROM A LARGE PROSTATE CANCER REFERENCE CENTER Idir Ouzaid, Evanguelos Xylinas, Belas Olivier, Guillaume Ploussard, Mohamed Bouanane, Alain Rahmouni, Clément-Claude Abbou, Alexandre de La Taille, and Laurent Salomon Idir OuzaidIdir Ouzaid Creteil, France More articles by this author , Evanguelos XylinasEvanguelos Xylinas Creteil, France More articles by this author , Belas OlivierBelas Olivier Creteil, France More articles by this author , Guillaume PloussardGuillaume Ploussard Creteil, France More articles by this author , Mohamed BouananeMohamed Bouanane Creteil, France More articles by this author , Alain RahmouniAlain Rahmouni Creteil, France More articles by this author , Clément-Claude AbbouClément-Claude Abbou Creteil, France More articles by this author , Alexandre de La TailleAlexandre de La Taille Creteil, France More articles by this author , and Laurent SalomonLaurent Salomon Creteil, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1442AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Magnetic Resonance Imaging (MRI) has become a widespread preoperative finding in the management of prostate cancer (PCa). Nowadays, the challenge in local staging for urologists is to better predict an organ confined disease in order to offer a nerve sparing surgery for patient eligible for radical prostatectomy (RP). Our aim was to evaluate the added value of a routine MRI in the local Staging of PCa. METHODS From January 2000 to June 2011, 1272 patients were referred to our center for PCa and underwent a pelvic MRI followed by radical prostatectomy (RP). MRI studies were performed on a 1.5-T whole body MR scanner using a balloon-design endorectal coil. The MRI protocol consisted in a routine T1, Gadolinium-enhanced T1 and T2 weighted sequences. Images were obtained in three orthogonal planes and 3-mm slice thickness. The readers sorted the tumors as: iT2, iT3a, iT3b, and iT4 tumors. All patients underwent a preoperative pelvic MRI followed by a RP. After the RP, final pathological staging (pTNM); were compared to the MRI findings (iTNM). MRI performance for local staging of PCa was evaluated Sensitivity (Se), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy for cancer detection were calculated. RESULTS The mean age and the serum PSA level of the study population were 62 (range: 41-78) years old and 9.78 (range: 0.9-118) ng/ml respectively. Of all, 750 (59%) patients had an organ confined tumor. The (95% IC) MRI sensitivity (Se), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and accuracy to predict an organ confined disease, extra-capsular extension, and seminal vesicle extension are shown in table 1. Staging Se Sp PPV NPV Accuracy Organ Confined tumor 0.82 0.40 0.67 0.60 0.65 Extra capsular extension 0.25 0.83 0.42 0.72 0.67 Seminal Vesicle invasion 0.27 0.92 0.32 0.92 0.87 CONCLUSIONS This study showed that routine MRI predicts extra capsular disease with better specificity and a better negative predictive value. Therefore, it is more valuable for the clinician when it is negative. This imaging should be more investigated and standardized in order to improve its prediction power. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e656-e657 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Idir Ouzaid Creteil, France More articles by this author Evanguelos Xylinas Creteil, France More articles by this author Belas Olivier Creteil, France More articles by this author Guillaume Ploussard Creteil, France More articles by this author Mohamed Bouanane Creteil, France More articles by this author Alain Rahmouni Creteil, France More articles by this author Clément-Claude Abbou Creteil, France More articles by this author Alexandre de La Taille Creteil, France More articles by this author Laurent Salomon Creteil, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...