Endorectal MR imaging of prostate cancer

Evaluation of tumor capsular contact length as a sign of extracapsular extension

Gustavo Mendez, Bryan Foster, Xin Li, Jackilen (Jackie) Shannon, Mark Garzotto, Christopher Amling, Fergus Coakley

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the length of contact between dominant tumor foci and the prostatic capsule as a sign of extracapsular extension at endorectal multiparametric MR imaging. Materials and methods: We retrospectively identified 101 patients over a three-year interval who underwent endorectal multiparametric prostate MR imaging prior to radical prostatectomy for prostate cancer. Two readers identified the presence of dominant tumor focus (largest lesion with PI-RADS version 2 score of 4 or 5), and measured the length of tumor capsular contact and likelihood of extracapsular extension by standard criteria (1–5 Likert scale). Results were analyzed using histopathological review as reference standard. Results: Extracapsular extension was found at histopathological review in 27 patients. Reader 1 (2) identified dominant tumor in 79 (73) patients, with mean tumor capsular contact length of 18.2 (14.0) mm. The area under the receiver operating characteristic curve for identification of extracapsular extension by tumor capsular contact length was 0.76 for reader 1 and 0.77 for reader 2, with optimal discrimination at values of 18 mm and 21 mm, respectively. In the subset of patients without obvious extracapsular extension by standard criteria (Likert scores 1–3), corresponding values were 0.74 and 0.66 with optimal thresholds of 24 and 21 mm. Conclusion: Length of contact between the dominant tumor focus and the capsule is a moderately useful sign of extracapsular extension at endorectal multiparametric prostate MR imaging, including the subset of patients without obvious extracapsular extension by standard criteria, with optimal discrimination at threshold values of 18 to 24 mm.

Original languageEnglish (US)
Pages (from-to)280-285
Number of pages6
JournalClinical Imaging
Volume50
DOIs
StatePublished - Jul 1 2018

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Prostatic Neoplasms
Neoplasms
Capsules
Prostate
Prostatectomy
ROC Curve

Keywords

  • Extracapsular extension
  • MR imaging
  • Prostate cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Endorectal MR imaging of prostate cancer : Evaluation of tumor capsular contact length as a sign of extracapsular extension. / Mendez, Gustavo; Foster, Bryan; Li, Xin; Shannon, Jackilen (Jackie); Garzotto, Mark; Amling, Christopher; Coakley, Fergus.

In: Clinical Imaging, Vol. 50, 01.07.2018, p. 280-285.

Research output: Contribution to journalArticle

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abstract = "Objective: To evaluate the length of contact between dominant tumor foci and the prostatic capsule as a sign of extracapsular extension at endorectal multiparametric MR imaging. Materials and methods: We retrospectively identified 101 patients over a three-year interval who underwent endorectal multiparametric prostate MR imaging prior to radical prostatectomy for prostate cancer. Two readers identified the presence of dominant tumor focus (largest lesion with PI-RADS version 2 score of 4 or 5), and measured the length of tumor capsular contact and likelihood of extracapsular extension by standard criteria (1–5 Likert scale). Results were analyzed using histopathological review as reference standard. Results: Extracapsular extension was found at histopathological review in 27 patients. Reader 1 (2) identified dominant tumor in 79 (73) patients, with mean tumor capsular contact length of 18.2 (14.0) mm. The area under the receiver operating characteristic curve for identification of extracapsular extension by tumor capsular contact length was 0.76 for reader 1 and 0.77 for reader 2, with optimal discrimination at values of 18 mm and 21 mm, respectively. In the subset of patients without obvious extracapsular extension by standard criteria (Likert scores 1–3), corresponding values were 0.74 and 0.66 with optimal thresholds of 24 and 21 mm. Conclusion: Length of contact between the dominant tumor focus and the capsule is a moderately useful sign of extracapsular extension at endorectal multiparametric prostate MR imaging, including the subset of patients without obvious extracapsular extension by standard criteria, with optimal discrimination at threshold values of 18 to 24 mm.",
keywords = "Extracapsular extension, MR imaging, Prostate cancer",
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