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Value of preoperative 3T multiparametric MRI for surgical margin status in patients with prostate cancer
Author(s) -
Tamada Tsutomu,
Sone Teruki,
Kanomata Naoki,
Miyaji Yoshiyuki,
Kido Ayumu,
Jo Yoshimasa,
Yamamoto Akira,
Ito Katsuyoshi
Publication year - 2016
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.25185
Subject(s) - medicine , effective diffusion coefficient , prostate cancer , institutional review board , magnetic resonance imaging , mann–whitney u test , logistic regression , exact test , nuclear medicine , biopsy , radiology , multiparametric mri , cancer , surgery
Purpose To examine the value of preoperative multiparametric magnetic resonance imaging (MRI) as a predictor of surgical margin (SM) status in patients with prostate cancer (PC). Materials and Methods The Institutional Review Board approved this retrospective study; the requirement for informed consent was waived. Fifty‐six male patients with histologically proven PC underwent preoperative 3T multiparametric MRI including high b value (0, 2000 s/mm 2 ) diffusion‐weighted imaging. In each patient, clinical data, such as biopsy Gleason score and D'Amico clinical risk score, and multiparametric MRI findings, such as tumor location, tumor size, tumor extension in the apical or proximal region, tumor apparent diffusion coefficient (ADC), and the presence or absence of MRI findings of extracapsular extension (ECE) were evaluated. Statistical evaluations included the Fisher's exact test, χ 2 test, Mann–Whitney U ‐test, and logistic regression analysis. Results On histopathological evaluation, 15 patients (27%) were SM‐positive (SMP group), and 41 (73%) were SM‐negative (SMN group). The tumor ADC was significantly lower in the SMP group than in the SMN group ( P = 0.001). The frequency of tumor extension in the apex or base and suspected ECE on MRI were significantly higher in the SMP group than in the SMN group ( P = 0.037 and 0.011, respectively). On multivariate analysis, tumor ADC was the only predictor of SM status in PC ( P = 0.003). Conclusion PC with positive SM was characterized by tumor extension in the apical and proximal regions, lower tumor ADC, and tumors with positive MRI findings of ECE, compared to tumors with negative SM. J. Magn. Reson. Imaging 2016;44:584–593.