A comparative analysis of techniques for measuring tumor contact length in predicting extraprostatic extension

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2024-09-21 DOI:10.1016/j.ejrad.2024.111753

Umut Asfuroğlu , Berrak Barutcu Asfuroğlu , Halil Özer , Mehmet Arda İnan , Murat Uçar

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引用次数: 0

Abstract

Purpose

This study aims to evaluate the diagnostic performance of curvilinear and linear measurement methods in different magnetic resonance imaging (MRI) sequences for detecting extraprostatic extension (EPE) in prostate cancer, and to evaluate the added value of apparent diffusion coefficient (ADC) in detecting EPE.

Methods

A retrospective analysis was conducted on 84 patients who underwent multiparametric MRI (mp-MRI) prior to radical prostatectomy between January 2019 and February 2022. Tumor contact length (TCL) was assessed curvilinearly and linearly on T2-weighted imaging (T2WI), ADC maps, and dynamic contrast-enhanced (DCE) MRI by two radiologists. MRI-based EPE positivity was defined as a curvilinear or linear contact length of >15 mm. Statistical comparisons were conducted using chi-squared and independent samples t-tests, with interreader agreement evaluated using weighted κ statistics. Univariate and multivariate logistic regression identified independent predictors of EPE, and two prediction models were constructed. Diagnostic performance was assessed using receiver operator characteristic (ROC) curve analysis.

Results

A total of 32 (38%) and 52 (62%) patients with EPE and non-EPE, respectively, were included in this study. Patients with EPE demonstrated significantly larger tumor sizes, lower ADC values, and lower ADC ratios than those without EPE (p < 0.001). The curvilinear and linear TCL measurements for each sequence exhibited statistically significant correlations with EPE for both readers, with strong interreader agreement. Curvilinear TCL (c-TCL) and linear TCL (l-TCL) on DCE-MRI showed higher area under the curve (AUC) values than the other measurements for EPE prediction (reader 1: 0.815 and 0.803, reader 2: 0.746 and 0.713, respectively). However, there was no statistically significant difference between c-TCL and l-TCL. Multivariable models with mean ADC value improved predictive performance. Model 2 (ADC, ISUP, and c-TCL on DCE images) surpassed model 1 (ADC and c-TCL on DCE images) with an AUC of 0.919 and 0.874, respectively.

Conclusion

DCE-MRI demonstrated superior performance in predicting EPE compared to other sequences. Linear and curvilinear measurements had comparable diagnostic performance. Being more practical and easier, radiologists may use l-TCL measurement in daily practice. The mean ADC value provided additional diagnostic value.

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预测前列腺外延伸的肿瘤接触长度测量技术比较分析

目的本研究旨在评估不同磁共振成像（MRI）序列中曲线和线性测量方法在检测前列腺癌前列腺体外延伸（EPE）方面的诊断性能，并评估表观弥散系数（ADC）在检测EPE方面的附加值。方法对2019年1月至2022年2月期间接受根治性前列腺切除术前接受多参数磁共振成像（mp-MRI）的84例患者进行了回顾性分析。肿瘤接触长度（TCL）由两名放射科医生通过T2加权成像（T2WI）、ADC图和动态对比增强（DCE）磁共振成像进行曲线和线性评估。基于 MRI 的 EPE 阳性定义为曲线或直线接触长度达到 15 毫米。统计比较采用卡方检验和独立样本t检验，读片者之间的一致性采用加权κ统计进行评估。单变量和多变量逻辑回归确定了 EPE 的独立预测因素，并构建了两个预测模型。本研究分别纳入了 32 例（38%）和 52 例（62%）EPE 和非 EPE 患者。与非 EPE 患者相比，EPE 患者的肿瘤体积明显更大，ADC 值更低，ADC 比值也更低（p < 0.001）。两种读取器对每个序列的曲线和线性 TCL 测量结果均与 EPE 存在统计学意义上的显著相关性，读取器之间的一致性很强。在预测 EPE 方面，DCE-MRI 的曲线 TCL（c-TCL）和线性 TCL（l-TCL）的曲线下面积（AUC）值高于其他测量值（读者 1：分别为 0.815 和 0.803；读者 2：分别为 0.746 和 0.713）。但是，c-TCL 和 l-TCL 之间没有统计学意义上的显著差异。带有平均 ADC 值的多变量模型提高了预测性能。模型 2（DCE 图像上的 ADC、ISUP 和 c-TCL）的 AUC 分别为 0.919 和 0.874，超过了模型 1（DCE 图像上的 ADC 和 c-TCL）。线性测量和曲线测量的诊断性能相当。l-TCL测量更实用、更简便，放射科医生可在日常工作中使用。平均 ADC 值提供了额外的诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.