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