- 作者：Philippe Puech ; Eric Potiron ; Laurent Lemaitre ; Xavier Leroy ; Georges-Pascal Haber ; Sebastien Crouzet ; Kazumi Kamoi ; Arnauld Villers
- 刊名：Urology
- 出版年：2009
- 出版时间：November 2009
- 年：2009
- 卷：74
- 期：5
- 页码：1094-1099
- 全文大小：650 K
Objectives
To determine the diagnostic performance of dynamic contrast-enhanced–magnetic resonance imaging (DCE-MRI) in the identification of intraprostatic cancer foci related to cancer volume at histopathology, in patients with clinically localized cancer treated by radical prostatectomy, with whole-mount histopathologic sections as the reference standard.Methods
Eighty-three consecutive radical prostatectomy specimens from patients referred for a prostate-specific antigen elevation were correlated with prebiopsy MRI. MRI results ranked on a 5-point scale were correlated with the findings of histopathology maps in 8 prostate sectors, including volume, largest surface area, and percentage of Gleason grade 4/5. The area under the receiver operating characteristic curve was used.
Results
Median prostate-specific antigen was 8.15 ng/mL. DCE-MRI was suspicious in 55 (66 % ) out of 83 patients. A separate cancer foci (mean 2.55 per patient) was present in 212 (34 % ) of 664 octants and DCE-MRI was suspicious in 68 of 212. Sensitivity and specificity of DCE-MRI at score 3.4 or 5 for identification of cancer foci at any volume was 32 % and 95 % , respectively. For identification of cancer foci > 0.5 mL, the sensitivity and specificity were 86 % and 94 % , respectively, with the under the receiver operating characteristic curve of 0.874. Mean volume of DCE-MRI detected and missed cancers were 2.44 mL (0.02-14.5) and 0.16 mL (0.005-2.4), respectively. Sensitivity and specificity of DCE-MRI for identification of > 10 % of Gleason grade 4/5 were 81 % and 82 % , respectively.
Conclusions
DCE-MRI can accurately identify intraprostatic cancer foci. Possible applications are guidance for biopsies, selection of patients for watchful waiting, and focal treatment planning.