Prostate cancer: Is inapparent tumor at endorectal MR and MR spectroscopic imaging a favorable prognostic finding in patients who select active surveillance?

Alvin R. Cabrera, Fergus Coakley, Antonio C. Westphalen, Ying Lu, Shoujun Zhao, Katsuto Shinohara, Peter R. Carroll, John Kurhanewicz

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Purpose: To retrospectively determine whether inapparent tumor at endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging is a favorable prognostic finding in prostate cancer patients who select active surveillance for management. Materials and Methods: Committee on Human Research approval was obtained and compliance with HIPAA regulations was observed, with waiver of requirement for written consent. Ninety-two men (mean age, 64 years; range, 43-85 years) were retrospectively identified who had biopsy-proved prostate cancer, who had undergone baseline endorectal MR imaging and MR spectroscopic imaging, and who had selected active surveillance for management. Their mean baseline serum prostate-specific antigen (PSA) level was 5.5 ng/ mL, and the median Gleason score was 6. Two readers with 10 and 3 years of experience independently reviewed all MR images and determined whether tumor was apparent on the basis of evaluation of established morphologic and metabolic findings. Another investigator compiled data about baseline clinical stage, biopsy findings, and serum PSA measurements. Multiple logistic regression analysis was used to investigate the relationship between the clinical parameters and tumor apparency at MR imaging and the biochemical outcome. Results: At baseline MR imaging, readers 1 and 2 considered 54 and 26 patients, respectively, to have inapparent tumor (fair interobserver agreement; κ = 0.30). During a mean follow-up of 4.8 years, 52 patients had a stable PSA level and 40 had an increasing PSA level. In multivariate analysis, no significant association was found between the baseline clinical stage, Gleason score, serum PSA level, or the presence of apparent tumor at endorectal MR imaging and MR spectroscopic imaging for either reader and the biochemical outcome (P > .05 for all). Conclusion: Endorectal MR imaging and MR spectroscopic imaging findings of tumor apparency or inapparency in prostate cancer patients who select active surveillance for management do not appear to be of prognostic value.

Original languageEnglish (US)
Pages (from-to)444-450
Number of pages7
JournalRadiology
Volume247
Issue number2
DOIs
StatePublished - May 2008
Externally publishedYes

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Prostatic Neoplasms
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Prostate-Specific Antigen
Neoplasms
Neoplasm Grading
Serum
Health Insurance Portability and Accountability Act
Biopsy
Multivariate Analysis
Logistic Models
Regression Analysis
Research Personnel
Research

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Prostate cancer : Is inapparent tumor at endorectal MR and MR spectroscopic imaging a favorable prognostic finding in patients who select active surveillance? / Cabrera, Alvin R.; Coakley, Fergus; Westphalen, Antonio C.; Lu, Ying; Zhao, Shoujun; Shinohara, Katsuto; Carroll, Peter R.; Kurhanewicz, John.

In: Radiology, Vol. 247, No. 2, 05.2008, p. 444-450.

Research output: Contribution to journalArticle

Cabrera, Alvin R. ; Coakley, Fergus ; Westphalen, Antonio C. ; Lu, Ying ; Zhao, Shoujun ; Shinohara, Katsuto ; Carroll, Peter R. ; Kurhanewicz, John. / Prostate cancer : Is inapparent tumor at endorectal MR and MR spectroscopic imaging a favorable prognostic finding in patients who select active surveillance?. In: Radiology. 2008 ; Vol. 247, No. 2. pp. 444-450.
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title = "Prostate cancer: Is inapparent tumor at endorectal MR and MR spectroscopic imaging a favorable prognostic finding in patients who select active surveillance?",
abstract = "Purpose: To retrospectively determine whether inapparent tumor at endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging is a favorable prognostic finding in prostate cancer patients who select active surveillance for management. Materials and Methods: Committee on Human Research approval was obtained and compliance with HIPAA regulations was observed, with waiver of requirement for written consent. Ninety-two men (mean age, 64 years; range, 43-85 years) were retrospectively identified who had biopsy-proved prostate cancer, who had undergone baseline endorectal MR imaging and MR spectroscopic imaging, and who had selected active surveillance for management. Their mean baseline serum prostate-specific antigen (PSA) level was 5.5 ng/ mL, and the median Gleason score was 6. Two readers with 10 and 3 years of experience independently reviewed all MR images and determined whether tumor was apparent on the basis of evaluation of established morphologic and metabolic findings. Another investigator compiled data about baseline clinical stage, biopsy findings, and serum PSA measurements. Multiple logistic regression analysis was used to investigate the relationship between the clinical parameters and tumor apparency at MR imaging and the biochemical outcome. Results: At baseline MR imaging, readers 1 and 2 considered 54 and 26 patients, respectively, to have inapparent tumor (fair interobserver agreement; κ = 0.30). During a mean follow-up of 4.8 years, 52 patients had a stable PSA level and 40 had an increasing PSA level. In multivariate analysis, no significant association was found between the baseline clinical stage, Gleason score, serum PSA level, or the presence of apparent tumor at endorectal MR imaging and MR spectroscopic imaging for either reader and the biochemical outcome (P > .05 for all). Conclusion: Endorectal MR imaging and MR spectroscopic imaging findings of tumor apparency or inapparency in prostate cancer patients who select active surveillance for management do not appear to be of prognostic value.",
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T2 - Is inapparent tumor at endorectal MR and MR spectroscopic imaging a favorable prognostic finding in patients who select active surveillance?

AU - Cabrera, Alvin R.

AU - Coakley, Fergus

AU - Westphalen, Antonio C.

AU - Lu, Ying

AU - Zhao, Shoujun

AU - Shinohara, Katsuto

AU - Carroll, Peter R.

AU - Kurhanewicz, John

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N2 - Purpose: To retrospectively determine whether inapparent tumor at endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging is a favorable prognostic finding in prostate cancer patients who select active surveillance for management. Materials and Methods: Committee on Human Research approval was obtained and compliance with HIPAA regulations was observed, with waiver of requirement for written consent. Ninety-two men (mean age, 64 years; range, 43-85 years) were retrospectively identified who had biopsy-proved prostate cancer, who had undergone baseline endorectal MR imaging and MR spectroscopic imaging, and who had selected active surveillance for management. Their mean baseline serum prostate-specific antigen (PSA) level was 5.5 ng/ mL, and the median Gleason score was 6. Two readers with 10 and 3 years of experience independently reviewed all MR images and determined whether tumor was apparent on the basis of evaluation of established morphologic and metabolic findings. Another investigator compiled data about baseline clinical stage, biopsy findings, and serum PSA measurements. Multiple logistic regression analysis was used to investigate the relationship between the clinical parameters and tumor apparency at MR imaging and the biochemical outcome. Results: At baseline MR imaging, readers 1 and 2 considered 54 and 26 patients, respectively, to have inapparent tumor (fair interobserver agreement; κ = 0.30). During a mean follow-up of 4.8 years, 52 patients had a stable PSA level and 40 had an increasing PSA level. In multivariate analysis, no significant association was found between the baseline clinical stage, Gleason score, serum PSA level, or the presence of apparent tumor at endorectal MR imaging and MR spectroscopic imaging for either reader and the biochemical outcome (P > .05 for all). Conclusion: Endorectal MR imaging and MR spectroscopic imaging findings of tumor apparency or inapparency in prostate cancer patients who select active surveillance for management do not appear to be of prognostic value.

AB - Purpose: To retrospectively determine whether inapparent tumor at endorectal magnetic resonance (MR) imaging and MR spectroscopic imaging is a favorable prognostic finding in prostate cancer patients who select active surveillance for management. Materials and Methods: Committee on Human Research approval was obtained and compliance with HIPAA regulations was observed, with waiver of requirement for written consent. Ninety-two men (mean age, 64 years; range, 43-85 years) were retrospectively identified who had biopsy-proved prostate cancer, who had undergone baseline endorectal MR imaging and MR spectroscopic imaging, and who had selected active surveillance for management. Their mean baseline serum prostate-specific antigen (PSA) level was 5.5 ng/ mL, and the median Gleason score was 6. Two readers with 10 and 3 years of experience independently reviewed all MR images and determined whether tumor was apparent on the basis of evaluation of established morphologic and metabolic findings. Another investigator compiled data about baseline clinical stage, biopsy findings, and serum PSA measurements. Multiple logistic regression analysis was used to investigate the relationship between the clinical parameters and tumor apparency at MR imaging and the biochemical outcome. Results: At baseline MR imaging, readers 1 and 2 considered 54 and 26 patients, respectively, to have inapparent tumor (fair interobserver agreement; κ = 0.30). During a mean follow-up of 4.8 years, 52 patients had a stable PSA level and 40 had an increasing PSA level. In multivariate analysis, no significant association was found between the baseline clinical stage, Gleason score, serum PSA level, or the presence of apparent tumor at endorectal MR imaging and MR spectroscopic imaging for either reader and the biochemical outcome (P > .05 for all). Conclusion: Endorectal MR imaging and MR spectroscopic imaging findings of tumor apparency or inapparency in prostate cancer patients who select active surveillance for management do not appear to be of prognostic value.

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