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Multiparametric 3T endorectal mri after external beam radiation therapy for prostate cancer
Author(s) -
Westphalen Antonio C.,
Reed Galen D.,
Vinh Phillip P.,
Sotto Christopher,
Vigneron Daniel B.,
Kurhanewicz John
Publication year - 2012
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.23672
Subject(s) - medicine , receiver operating characteristic , magnetic resonance imaging , prostate cancer , radiology , confidence interval , diffusion mri , radiation therapy , nuclear medicine , institutional review board , logistic regression , magnetic resonance spectroscopic imaging , cancer , surgery
Purpose: To determine the best combination of magnetic resonance imaging (MRI) parameters for the detection of locally recurrent prostate cancer after external beam radiation therapy. Materials and Methods: Our Institutional Review Board approved this study with a waiver of informed consent. Twenty‐six patients with suspected recurrence due to biochemical failure were part of this research. The MR protocol included T2‐weighted, MR spectroscopy, and diffusion‐weighted MRI. Transrectal ultrasound‐guided biopsy was the standard of reference. We used logistic regression to model the probability of a positive outcome and generalized estimating equations to account for clustering. The diagnostic performance of imaging was described using receiver operating characteristic (ROC) curves. Results: The area under the ROC curve of MR spectroscopic imaging (MRSI) was 83.0% (95% confidence interval [CI] = 75.5–89.1). The combination of all MR techniques did not significantly improve the performance of imaging beyond the accuracy of MRSI alone, but a trend toward improved discrimination was noted (86.9%; 95% CI = 77.6–93.4; P = 0.09). Conclusion: Incorporation of MRSI to T2‐weighted and/or diffusion‐weighted MRI significantly improves the assessment of patients with suspected recurrence after radiotherapy and a combined approach with all three modalities may have the best diagnostic performance. J. Magn. Reson. Imaging 2012;36:430–437. ©2012 Wiley Periodicals, Inc.