MP7-15 A PROSPECTIVE COMPARATIVE STUDY OF HISTOSCANNINGTM AND MULTIPARAMETRIC 3TESLA MRI FOR THE PREDICTION OF CANCER FOCI IN MEN UNDERGOING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyImaging/Radiology II1 Apr 2014MP7-15 A PROSPECTIVE COMPARATIVE STUDY OF HISTOSCANNINGTM AND MULTIPARAMETRIC 3TESLA MRI FOR THE PREDICTION OF CANCER FOCI IN MEN UNDERGOING RADICAL PROSTATECTOMY Clement Orczyk, Andrew B. Rosenkrantz, Fang-Ming Deng, James Wysock, Jonathan Melamed, and Samir S. Taneja Clement OrczykClement Orczyk More articles by this author , Andrew B. RosenkrantzAndrew B. Rosenkrantz More articles by this author , Fang-Ming DengFang-Ming Deng More articles by this author , James WysockJames Wysock More articles by this author , Jonathan MelamedJonathan Melamed More articles by this author , and Samir S. TanejaSamir S. Taneja More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.338AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Histoscanning (HS) is an ultrasound-based method using computer-aided analysis to assess tissue disorganization that has shown potential for prostate cancer detection in pilot studies. Our aim was to prospectively compare the ability of HS and multiparametric MRI (mpMRI) to predict the presence and location of cancer foci within the prostate among men undergoing robot-assisted radical prostatectomy (RP). METHODS 31 consecutive men who underwent 3T pelvic phased-array coil mpMRI (T2WI, DWI, DCE) prior to RP were enrolled in an IRB-approved evaluation of HS. Following induction of anesthesia, HS was performed on each patient prior to incision for RP. HS, mpMRI, and step-section histology were independently reviewed with reviewers blinded to results of the other tests. The prostate was then divided into 8 regions of interest (ROI) and disease maps were generated for each modality. Data was then evaluated by a committee of 5 reviewers to determine concordance of reported lesions between each imaging modality and histology. Generalized estimating equations based on binary logistic regression were used to model concordance between modalities. RESULTS 78/248 (31%) of ROIs were positive for cancer. Accuracy for detection of cancer within individual ROI was 82.6% and 65.3% for mpMRI and HS, respectively (p<0.001). While sensitivity by ROI did not differ between modalities (52.6% vs. 46.2%, P=0.3968), mpMRI was more specific (96.5% vs. 74.1%, p<0.0001). Within 78 positive ROI’s, 84 lesions were identified. The sensitivity for lesion detection was 50% for mpMRI, and 42.9% for HS (p=0.3768). Among lesions ≥10 mm (n=34), sensitivity was greater for mpMRI (82.4% vs 55.9%, p=.0352). Significant difference was noted for detection of lesions with Gleason score ≥7 (n=22; 86.4% vs. 50%; p=.0078) or primary Gleason grade ≥4 (n=6; 100% vs 33.3%, p=0.125). The overall PPV by lesion was 87.5% for mpMRI and 41.4% for HS (p<0.001). (e.g. figure1). CONCLUSIONS mpMRI showed greater accuracy in cancer detection both by ROI and individual lesion, due to superior specificity. Among individual lesions, both modalities showed relatively poor sensitivity, but mpMRI retained superior sensitivity for detection of larger, higher grade tumors. PPV was significantly better for mpMRI. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e72 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Clement Orczyk More articles by this author Andrew B. Rosenkrantz More articles by this author Fang-Ming Deng More articles by this author James Wysock More articles by this author Jonathan Melamed More articles by this author Samir S. Taneja More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...