Diagnosis of Extracapsular Extension of Prostate Cancer on Prostate MRI: Impact of Second-Opinion Readings by Subspecialized Genitourinary Oncologic Radiologists.

The purpose of this article is to investigate the added value of second-opinion evaluation of prostate MRI by subspecialized genitourinary oncologic radiologists for the assessment of extracapsular extension (ECE) of prostate cancer.

We performed a retrospective evaluation of initial and second-opinion radiology reports of 76 patients who underwent MRI of the prostate before prostatectomy for histologically proven prostate cancer. Initial outside reports and second-opinion reports were unpaired and reviewed in random order by a urologist who was blinded to patients' clinical details and histopathologic data. Histopathologic analysis of the prostatectomy specimen served as the reference standard.

Among cases with diagnostic-quality images available (71/76; 93%), disagreement between the initial report and the second-opinion report was observed in 30% of cases (21/71; κ = 0. 35); in 18 of these 21 cases (86%), histopathologic analysis proved that the second-opinion report was correct. The second-opinion interpretations had statistically significantly higher sensitivity (66% vs 24%; p < 0. 0001) than did the initial reports, whereas there was no statistically significant difference in specificity (87% vs 93%; p = 0. 317). On ROC curve analysis, the second-opinion reports yielded a statistically significantly higher AUC for the detection of ECE (0. 80 vs 0. 65; p = 0. 004).

The reinterpretation of prostate MRI examinations by subspecialized genitourinary oncologic radiologists improved the detection of ECE of prostate cancer.

AJR. American journal of roentgenology. 2015 Jul [Epub]

Andreas Wibmer, Hebert Alberto Vargas, Timothy F Donahue, Junting Zheng, Chaya Moskowitz, James Eastham, Evis Sala, Hedvig Hricak

1 Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. , 1 Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. , 2 Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY. , 3 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. , 3 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY. , 2 Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY. , 1 Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065. , 1 Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065.

PubMed

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe