Defining the role of multiparametric MRI in predicting prostate cancer extracapsular extension
Sanguedolce, Francesco (Institut de Recerca Sant Pau)
Tedde, Alessandro (Fundació Puigvert)
Granados, Luisa (Fundació Puigvert)
Hernández, Jonathan (Fundació Puigvert)
Robalino, Jorge (Fundació Puigvert)
Suquilanda, Edgar (Fundació Puigvert)
Tedde, Matteo (Università degli Studi di Sassari)
Palou, Juan (Institut de Recerca Sant Pau)
Breda, Alberto (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	To identify the predictive factors of prostate cancer extracapsular extension (ECE) in an institutional cohort of patients who underwent multiparametric MRI of the prostate prior to radical prostatectomy (RP). Overall, 126 patients met the selection criteria, and their medical records were retrospectively collected and analysed; 2 experienced radiologists reviewed the imaging studies. Logistic regression analysis was conducted to identify the variables associated to ECE at whole-mount histology of RP specimens; according to the statistically significant variables associated, a predictive model was developed and calibrated with the Hosmer-Lomeshow test. The predictive ability to detect ECE with the generated model was 81. 4% by including the length of capsular involvement (LCI) and intraprostatic perineural invasion (IPNI). The predictive accuracy of the model at the ROC curve analysis showed an area under the curve (AUC) of 0. 83 [95% CI (0. 76-0. 90)], p < 0. 001. Concordance between radiologists was substantial in all parameters examined (p < 0. 001). Limitations include the retrospective design, limited number of cases, and MRI images reassessment according to PI-RADS v2. 0. The LCI is the most robust MRI factor associated to ECE; in our series, we found a strong predictive accuracy when combined in a model with the IPNI presence. This outcome may prompt a change in the definition of PI-RADS score 5. The online version contains supplementary material available at 10. 1007/s00345-023-04720-5.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Extracapsular extension ; Multiparametric magnetic resonance imaging ; Nomogram ; Predictive models ; Prostate cancer ; Radical prostatectomy
Published in:	World Journal of Urology, Vol. 42 (january 2024) , ISSN 1433-8726

DOI: 10.1007/s00345-023-04720-5
PMID: 38217693

8 p, 668.4 KB

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