How Prostate Cancer Growth Patterns Impact Detection and Interreader Agreement on Multiparametric MRI.

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2024-12-05 DOI:10.1016/j.acra.2024.10.040

Daniel Hausmann, N Rupp, B Kuzmanic, N Spielhofer, J Heimer, V Koelzer, M Nowak, C Gampp, L Hefermehl, R A Kubik-Huch, G Singer, I A Burger

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引用次数: 0

Abstract

Rationale and objectives: Multiparametric MRI (mpMRI) substantially improves the detection of significant prostate carcinoma (PCa) compared to systematic biopsy. Nevertheless, mpMRI can overlook aggressive forms of PCa. Recent studies showed, that infiltrative growth (INF) has less restricted diffusion. This study aims to explore the impact of growth patterns on the detection of lesions.

Materials and methods: This retrospective study analyzed 52 patients who underwent radical prostatectomy, with preoperative mpMRI. For each patient, one dominant lesion was identified on one whole-mount prostatectomy section. Two pathologists (P1, P2) independently classified the growth pattern whether as expansive (EXP) being defined with at least three 5mm² regions of interest consisting entirely of carcinoma without benign glands or else as infiltrative (INF). Two radiologists (R1, R2) independently classified selected lesions according to PI-RADSv2.1. based on pathological localization. Apparent diffusion coefficient (ADC) values were measured in correlation with matched histopathology slides. Interreader-agreement was evaluated using weighted Cohen's Kappa. The relationship between PI-RADS scores and pathological diagnoses was analyzed using logistic regression.

Results: Pathologic lesion characterization regarding growth patterns achieved almost perfect agreement (κ = 0.88), so did PI-RADS classification of mpMRI (κ = 0.90). PI-RADS scores correlated significantly with EXP growth patterns. Average ADC values were lower for EXP lesions (0.83×10^-3 mm²/s, CI: 0.72-0.94×10^-3 mm²/s) compared to INF lesions (0.97×10^-3 mm²/s, CI: 0.86-1.07×10^-3 mm²/s; p = 0.08). On T2 images, 8 of 28 (29%) INF lesions and 1 of 24 (4%) EXP lesions were not visible.

Conclusion: PCa missed on mpMRI more frequently demonstrate INF growth patterns. Lesions with EXP growth patterns show lower ADC values and have higher PI-RADS scores.

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.