Detection and staging of radio-recurrent prostate cancer using multiparametric MRI.

Autor:	Kowa JY; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Soneji N; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Sohaib SA; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Mayer E; Department of Surgery, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK.; Department of Surgery & Cancer, St Mary's Hospital Campus, Imperial College London, Praed Street, London, UK., Hazell S; Department of Histopathology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Butterfield N; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Shur J; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK., Ap Dafydd D; Department of Radiology, The Royal Marsden NHS Foundation Trust, Chelsea, London, UK.
Jazyk:	angličtina
Zdroj:	The British journal of radiology [Br J Radiol] 2021 Apr 01; Vol. 94 (1120), pp. 20201423. Date of Electronic Publication: 2021 Feb 15.
DOI:	10.1259/bjr.20201423
Abstrakt:	Objective: We determined the sensitivity and specificity of multiparametric magnetic resonance imaging (MP-MRI) in detection of locally recurrent prostate cancer and extra prostatic extension in the post-radical radiotherapy setting. Histopathological reference standard was whole-mount prostatectomy specimens. We also assessed for any added value of the dynamic contrast enhancement (DCE) sequence in detection and staging of local recurrence. Methods: This was a single centre retrospective study. Participants were selected from a database of males treated with salvage prostatectomy for locally recurrent prostate cancer following radiotherapy. All underwent pre-operative prostate-specific antigen assay, positron emission tomography CT, MP-MRI and transperineal template prostate mapping biopsy prior to salvage prostatectomy. MP-MRI performance was assessed using both Prostate Imaging-Reporting and Data System v. 2 and a modified scoring system for the post-treatment setting. Results: 24 patients were enrolled. Using Prostate Imaging-Reporting and Data System v. 2, sensitivity, specificity, positive predictive value and negative predictive value was 64%, 94%, 98% and 36%. MP-MRI under staged recurrent cancer in 63%. A modified scoring system in which DCE was used as a co-dominant sequence resulted in improved diagnostic sensitivity (61%-76%) following subgroup analysis. Conclusion: Our results show MP-MRI has moderate sensitivity (64%) and high specificity (94%) in detecting radio-recurrent intraprostatic disease, though disease tends to be under quantified and under staged. Greater emphasis on dynamic contrast images in overall scoring can improve diagnostic sensitivity. Advances in Knowledge: MP-MRI tends to under quantify and under stage radio-recurrent prostate cancer. DCE has a potentially augmented role in detecting recurrent tumour compared with the de novo setting. This has relevance in the event of any future modified MP-MRI scoring system for the irradiated gland.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu