Detection of prostate cancer index lesions with multiparametric MRI (mp-MRI) using whole-mount histological sections as the reference standard.

To evaluate the sensitivity of mp-MRI for prostate cancer (PCa) foci, including index lesions.

115 patients with ultrasound biopsy confirmed PCa underwent mp-MRI, and radical prostatectomy. A single expert radiologist recorded all PCa foci including the largest (index) lesion blinded to pathologist's biopsy report.

The reference standard was 5 μm microsections obtained from 3mm thick whole mount histological sections All lesions were contoured by an experienced uropathologist who assessed their volume and pathological Gleason Score (pGS) PCas with volume>0 5 cc and/or pGS>6 were defined as clinically significant Multivariate analysis to describe the characteristics of lesions identified by MRI was performed The study received approval by the local ethical board and was conducted according to the principles of the Helsinki Declaration

Mp-MRI correctly diagnosed 104/115 index lesions (sensitivity=90 4%; 95% CI 83 5%-95 1%), including 98/105 clinically significant index lesions (93 3%; 95% CI=86 8%-97 3%) among which 3/3 lesions with volume6 Overall mp-MRI detected 131/206 lesions including 13 of 68 insignificant PCa The multivariate logistic regression modeling showed that pGS value (ORs, 11 7; 95% CI: 2 3-59 8; P=0 003) and lesion volume (ORs, 4 24; 95% CI: 1 3-14 7; P=0 022) were independently associated to detection of index lesion at MRI

This study shows that mp-MRI has a high sensitivity in the detection of clinically significant PCa index lesions, while it has disappointing results in the detection of small volume low pGS prostate cancer foci Mp-MRI may be used to stratify patients according to risk, allowing better treatment selection This article is protected by copyright All rights reserved

BJU international 2015 Jul 20 [Epub ahead of print]

Filippo Russo, Daniele Regge, Enrico Armando, Valentina Giannini, Anna Vignati, Simone Mazzetti, Matteo Manfredi, Enrico Bollito, Loredana Correale, Francesco Porpiglia

Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Department of Radiology, Candiolo Cancer Institute - FPO, IRCCS, Strada Provinciale 142, Km 3 95, 10060, Candiolo, Italy , Division of Urology, Department of Clinical and Biological Science, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy , Division of Pathology, Department of Clinical and Biological Sciences, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy , im3D S p A , Via Lessolo, 3, 10153, Torino, Italy , Division of Urology, Department of Clinical and Biological Science, Azienda Ospedaliero-Universitaria San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy

PubMed

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