A prospective comparative analysis of the accuracy of HistoScanning and multiparametric magnetic resonance imaging in the localization of prostate cancer among men undergoing radical prostatectomy

Autor: Jonathan Melamed, Fang Ming Deng, James Babb, Clement Orczyk, Michael D. Stifelman, Samir S. Taneja, James S. Wysock, Herbert Lepor, Emil Kheterpal, William C. Huang, Andrew B. Rosenkrantz
Přispěvatelé: Department of Urology, New York University Langone Medical Center, New York, NY, New York University [New York] (NYU), NYU System (NYU)-NYU System (NYU), Département de Chirurgie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales (ISTCT), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Department of Radiology, New York University Langone Medical Center, New York, NY, Department of Pathology, New York University Langone Medical Center, New York, NY, Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Urologic Oncology: Seminars and Original Investigations
Urologic Oncology: Seminars and Original Investigations, 2016, 34 (1), pp.3.e1-3.e8. ⟨10.1016/j.urolonc.2015.07.004⟩
Urologic Oncology: Seminars and Original Investigations, Elsevier, 2016, 34 (1), pp.3.e1-3.e8. ⟨10.1016/j.urolonc.2015.07.004⟩
ISSN: 1078-1439
DOI: 10.1016/j.urolonc.2015.07.004⟩
Popis: Introduction There is increasing interest in using imaging in the detection and localization of prostate cancer (PCa). Both multiparametric magnetic resonance imaging (mpMRI) and HistoScanning (HS) have been independently evaluated in the detection and localization of PCa. We undertook a prospective, blinded comparison of mpMRI and HS for cancer localization among men undergoing radical prostatectomy. Methods Following approval by the institutional review board, men scheduled to undergo radical prostatectomy, who had previously undergone mpMRI at our institution, were offered inclusion in the study. Those consenting underwent preoperative HS following induction of anesthesia; mpMRI, HS, and surgical step-section pathology were independently read by a single radiologist, urologist, and pathologist, respectively, in a blinded fashion. Disease maps created by each independent reader were compared and evaluated for concordance by a 5 persons committee consisting of 2 urologists, 2 pathologists, and 1 radiologist. Logistic regression for correlated data was used to assess and compare mpMRI and HS in terms of diagnostic accuracy for cancer detection. Generalized estimating equations based on binary logistic regression were used to model concordance between reader opinion and the reference standard assessment of the same lesion site or region as a function of imaging modality. Results Data from 31/35 men enrolled in the trial were deemed to be evaluable. On evaluation of cancer localization, HS identified cancer in 36/78 (46.2%) regions of interest, as compared with 41/78 (52.6%) on mpMRI (P = 0.3968). The overall accuracy, positive predictive value, negative predictive value, and specificity for detection of disease within a region of interest were significantly better with mpMRI as compared with HS. HS detected 36/84 (42.9%) cancer foci as compared with 42/84 (50%) detected by mpMRI (P = 0.3678). Among tumors with Gleason score>6, mpMRI detected 19/22 (86.4%) whereas HS detected only 11/22 (50%, P = 0.0078). Similarly, among tumors>10 mm in maximal diameter, mpMRI detected 28/34 (82.4%) whereas HS detected only 19/34 (55.9%, P = 0.0352). Conclusion In our institution, the diagnostic accuracy of HS was inferior to that of mpMRI in PCa for PCa detection and localization. Although our study warrants validation from larger cohorts, it would suggest that the HS protocol requires further refinement before clinical implementation.
Databáze: OpenAIRE
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