Detection rate and characteristics of prostate cancer foci on multi-parametric MRI (mp-MRI) using whole mount section as a reference standard-a single center clinical study
10.3760/cma.j.cn112330-20200321-00216
- VernacularTitle:mp-MRI对前列腺癌诊断的敏感性及影响因素——基于前列腺癌病理大切片的单中心临床研究
- Author:
Miao WANG
1
;
Xuan WANG
;
Huimin HOU
;
Yadong CUI
;
Wei ZHANG
;
Lingfeng MENG
;
Chunmei LI
;
Jianye WANG
;
Ming LIU
Author Information
1. 北京医院泌尿外科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730（为中国医学科学院北京协和医学院研究生院博士研究生，北京 100730）
- From:
Chinese Journal of Urology
2020;41(10):746-751
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the detection rate and the characteristics of detected prostate cancer foci on multi-parametric MRI (mp-MRI) and to evaluate the potential influence factors.Methods:A total of 66 patients undergoing radical prostatectomy (RP) from August 2017 to July 2019 in Beijing Hospital were retrospectively studied. The median age was 67(56-80)years, with the median preoperative PSA level of 8.73 (1.22-72.46)ng/ml, and median prostate volume of 35.9(16.8-131.8) ml. All patients underwent mp-MRI before surgery and the whole mount section of RP specimens was prepared. Two radiologists reviewed all the foci independently and then matched each foci with an urological pathologist. The primary outcome was the detection rate of prostate cancer. The potential influence factors were also investigated.Results:Of all 66 patients, a total of 62(93.9%) patients were diagnosed with prostate cancer on a preoperative mp-MRI. On whole mount section, 109 prostate cancer foci were detected, of which 77 foci were correctly diagnosed on mp-MRI, with the overall sensitivity of 70.6%. For all the foci detected, 53(48.6%) were grade group 1 disease of International Society of Urological pathology (ISUP), 31(27.5%) were ISUP grade group 2 disease, 19(17.4%) were ISUP grade group 3 disease, and 6(5.5%) were ≥ISUP grade group 4 disease. Mp-MRI detected 62/67(92.5%) lesions with tumor diameter ≥1 cm, 49/56(87.5%) lesions with tumor Gleason score ≥7, and 59/66(89.4%) index lesions. The tumor diameter( OR=3.183, 95% CI 1.580-6.411, P=0.001)and index lesion status( OR=4.042, 95% CI 1.127-14.503, P=0.032)were independently associated with the detection of prostate cancer foci on mp-MRI. Conclusions:mp-MRI is an effective technique for prostate cancer detection. Sensitivity increased with increased tumor size and index lesion status. The tumor diameter and index lesion status were independently associated with the detection of prostate cancer foci on mp-MRI.
