The value of adding dynamic contrast-enhanced (DCE) imaging to T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) to improve the detection and staging of prostate cancer (PCa) is unclear. The aim of this retrospective study was to compare the diagnostic performance of non-contrast biparametric MRI (bpMRI) with multiparametric MRI (mpMRI), for local staging of PCa.
Ninety-two patients who underwent prostate MRI on a 3-Tesla MRI system before radical prostatectomy for PCa were included retrospectively. Four readers independently assigned a Likert score (ranging from 1 to 5) for predicting extra-prostatic extension (EPE) on T2W + DWI (bpMRI) and then on T2W + DWI + DCE imaging (mpMRI). MRI-based staging results were compared with radical prostatectomy histology. A prediction of EPE generalized linear mixed model was used to assess the added-value of DCE and discriminative power of staging accuracy by area under the receiver-operating curve (AUC ROC).
AUC was not significantly improved by DCE (mpMRI, AUC = 0.73 [95%CI: 0.655‒0.827] vs. bpMRI, AUC = 0.76 [95%CI: 0.681‒0.846]). After applying a selection procedure, only MRI criteria were retained in a multivariate model. The following criteria were significantly associated with local extension: localization in the peripheral zone (p < 0.001), maximal diameter of the lesion (<0.0001), curvilinear capsular contact on T2W (p < 0.0001), capsular irregularity on T2W (p < 0.0001), bulging on T2W (p < 0.001) and seminal vesicle hypo-signal (p < 0.001).
Use of bpMRI did not result in a decrease in local staging accuracy.
European journal of radiology. 2020 Oct 15 [Epub ahead of print]
Charlotte Christophe, Sarah Montagne, Stéphanie Bourrelier, Morgan Roupret, Eric Barret, François Rozet, Eva Comperat, Jean François Coté, Olivier Lucidarme, Olivier Cussenot, Benjamin Granger, Raphaële Renard Penna
Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France., Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Academic Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France., Academic Department of Urology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France., Montsouris Institute, Urology Department, Paris, F-75014, France., Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France; Academic Department of Pathology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France., Academic Department of Pathology, Hôpital Pitié-Salpetrière, Assistance Publique des Hôpitaux de Paris, Paris, France., Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France; Academic Department of Urology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France., Department of Public Health, Pitié-Salpétrière Academic Hospital, AP-HP, Sorbonne Universités, AP-HP, CIC-P 1421, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR 1136, CIC-1421, Hôpital Pitié Salpêtrière, AP-HP, Paris, France., Academic Department of Radiology, Hôpital Pitié-Salpétrière, Assistance Publique des Hôpitaux de Paris, Paris, France; Academic Department of Radiology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France; Sorbonne Universités, GRC n° 5, Oncotype-Uro, Paris, France. Electronic address: .