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Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer
OBJECTIVE: To determine whether evaluating the mean apparent diffusion coefficient (ADC) together with capsular contact (CC) adds value in the prediction of microscopic extracapsular extension (ECE) of prostate cancer. MATERIALS AND METHODS: Between January 2012 and December 2016, 383 patients under...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720667/ https://www.ncbi.nlm.nih.gov/pubmed/33304005 http://dx.doi.org/10.1590/0100-3984.2019.0123 |
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author | da Silva Filho, Antonio Cordeiro Rocha, Tamara Oliveira Elias Jr, Jorge Barros, Marcus Vinicius de Castro Silva, Alfredo Ribeiro dos Reis, Rodolfo Borges Muglia, Valdair Francisco |
author_facet | da Silva Filho, Antonio Cordeiro Rocha, Tamara Oliveira Elias Jr, Jorge Barros, Marcus Vinicius de Castro Silva, Alfredo Ribeiro dos Reis, Rodolfo Borges Muglia, Valdair Francisco |
author_sort | da Silva Filho, Antonio Cordeiro |
collection | PubMed |
description | OBJECTIVE: To determine whether evaluating the mean apparent diffusion coefficient (ADC) together with capsular contact (CC) adds value in the prediction of microscopic extracapsular extension (ECE) of prostate cancer. MATERIALS AND METHODS: Between January 2012 and December 2016, 383 patients underwent multiparametric magnetic resonance imaging (mpMRI) of the prostate. A total of 67 patients were selected for inclusion. Two radiologists (observers 1 and 2), working independently, performed qualitative and quantitative analyses of ECE, macroscopic ECE, and microscopic ECE. A third radiologist assessed the correlation with the clinical data, and two experienced pathologists reviewed all histopathological findings. RESULTS: Among the 67 patients, mpMRI showed lesions that were confined to the capsule in 44 (66.7%), had microscopic ECE in 12 (17.9%), and had macroscopic ECE in 11 (16.4%). There were no significant differences, in terms of the diagnostic accuracy, as measured by determining the area under the curve (AUC), of CC on T2-weighted images (CCT2), CC on diffusion-weighted imaging (CCDWI), and the mean ADC for the prediction of microscopic ECE, between observer 1 (AUC of 0.728, 0.691, and 0.675, respectively) and observer 2 (AUC of 0.782, 0.821, and 0.799, respectively). Combining the mean ADC with the CCT2 or CCDWI did not improve the diagnostic accuracy for either observer. There was substantial interobserver agreement for the qualitative evaluation of ECE, as demonstrated by the kappa statistic, which was 0.77 (0.66-0.87). The diagnostic accuracy (AUC) of the qualitative assessment for predicting microscopic ECE was 0.745 for observer 1 and 0.804 for observer 2, and the difference was less than significant. In a multivariate analysis, none of clinical or imaging parameters were found to be associated with ECE. CONCLUSION: For the detection of microscopic ECE on mpMRI, CC appears to have good diagnostic accuracy, especially if the observer has considerable experience. Adding the mean ADC to the CCT2 or CCDWI does not seem to provide any significant improvement in that diagnostic accuracy. |
format | Online Article Text |
id | pubmed-7720667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem |
record_format | MEDLINE/PubMed |
spelling | pubmed-77206672020-12-09 Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer da Silva Filho, Antonio Cordeiro Rocha, Tamara Oliveira Elias Jr, Jorge Barros, Marcus Vinicius de Castro Silva, Alfredo Ribeiro dos Reis, Rodolfo Borges Muglia, Valdair Francisco Radiol Bras Original Article OBJECTIVE: To determine whether evaluating the mean apparent diffusion coefficient (ADC) together with capsular contact (CC) adds value in the prediction of microscopic extracapsular extension (ECE) of prostate cancer. MATERIALS AND METHODS: Between January 2012 and December 2016, 383 patients underwent multiparametric magnetic resonance imaging (mpMRI) of the prostate. A total of 67 patients were selected for inclusion. Two radiologists (observers 1 and 2), working independently, performed qualitative and quantitative analyses of ECE, macroscopic ECE, and microscopic ECE. A third radiologist assessed the correlation with the clinical data, and two experienced pathologists reviewed all histopathological findings. RESULTS: Among the 67 patients, mpMRI showed lesions that were confined to the capsule in 44 (66.7%), had microscopic ECE in 12 (17.9%), and had macroscopic ECE in 11 (16.4%). There were no significant differences, in terms of the diagnostic accuracy, as measured by determining the area under the curve (AUC), of CC on T2-weighted images (CCT2), CC on diffusion-weighted imaging (CCDWI), and the mean ADC for the prediction of microscopic ECE, between observer 1 (AUC of 0.728, 0.691, and 0.675, respectively) and observer 2 (AUC of 0.782, 0.821, and 0.799, respectively). Combining the mean ADC with the CCT2 or CCDWI did not improve the diagnostic accuracy for either observer. There was substantial interobserver agreement for the qualitative evaluation of ECE, as demonstrated by the kappa statistic, which was 0.77 (0.66-0.87). The diagnostic accuracy (AUC) of the qualitative assessment for predicting microscopic ECE was 0.745 for observer 1 and 0.804 for observer 2, and the difference was less than significant. In a multivariate analysis, none of clinical or imaging parameters were found to be associated with ECE. CONCLUSION: For the detection of microscopic ECE on mpMRI, CC appears to have good diagnostic accuracy, especially if the observer has considerable experience. Adding the mean ADC to the CCT2 or CCDWI does not seem to provide any significant improvement in that diagnostic accuracy. Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2020 /pmc/articles/PMC7720667/ /pubmed/33304005 http://dx.doi.org/10.1590/0100-3984.2019.0123 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article da Silva Filho, Antonio Cordeiro Rocha, Tamara Oliveira Elias Jr, Jorge Barros, Marcus Vinicius de Castro Silva, Alfredo Ribeiro dos Reis, Rodolfo Borges Muglia, Valdair Francisco Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title | Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title_full | Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title_fullStr | Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title_full_unstemmed | Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title_short | Value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
title_sort | value of adding the apparent diffusion coefficient to capsular contact for the prediction of extracapsular extension in prostate cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7720667/ https://www.ncbi.nlm.nih.gov/pubmed/33304005 http://dx.doi.org/10.1590/0100-3984.2019.0123 |
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