Impact of Endorectal Coil Use on Extraprostatic Extension Detection in Prostate MRI: A Retrospective Monocentric Study.

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

Academic Radiology Pub Date : 2025-01-13 DOI:10.1016/j.acra.2024.12.056

Omer Tarik Esengur, Enis C Yilmaz, Benjamin D Simon, Stephanie A Harmon, David G Gelikman, Yue Lin, Mason J Belue, Maria J Merino, Sandeep Gurram, Bradford J Wood, Peter L Choyke, Peter A Pinto, Baris Turkbey

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引用次数: 0

Abstract

Rationale and objectives: Accurate preoperative mpMRI-based detection of extraprostatic extension (EPE) in prostate cancer (PCa) is critical for surgical planning and patient outcomes. This study aims to evaluate the impact of endorectal coil (ERC) use on the diagnostic performance of mpMRI in detecting EPE.

Materials and methods: This retrospective study with prospectively collected data included participants who underwent mpMRI and subsequent radical prostatectomy for PCa between 2007 and 2024. Participants were divided based on ERC use on mpMRI: MRI without ERC and with ERC. Surgical pathology reports were used to determine the patients with pathologic EPE on whole-mount histopathology. One radiologist evaluated mpMRI using an in-house (National Cancer Institute [NCI]) EPE grading system. Logistic regression (LR) analyses were conducted to identify significant predictors of pathologic EPE, including ERC use and NCI EPE grades.

Results: 934 men (median age: 62 years [IQR = 57-67]) were included. For NCI EPE grade≥1, ERC MRI group (n = 612) had higher NPV (91% [320/353] vs. 83% [166/200], p = 0.01) and sensitivity (75% [101/134] vs. 62% [56/90], p = 0.04) compared to non-ERC group (n = 322). For NCI EPE grade = 3, ERC MRI group had higher NPV (83% [452/546] vs. 75% [221/294], p = 0.01) and accuracy (80% [492/612] vs. 74% [238/322], p = 0.03). In multivariable LR, higher NCI EPE grades were strong independent predictors of pathologic EPE, irrespective of ERC use (NCI EPE grade 2 with ERC: odds ratio [OR] = 2.01, p = 0.04; without ERC: OR = 5.63, p<0.001, NCI EPE grade 3 with ERC: OR = 4.53, p<0.001; without ERC: OR = 5.22, p = 0.002).

Conclusion: ERC improves sensitivity, NPV, accuracy of EPE detection with mpMRI at different NCI EPE thresholds. NCI EPE grading system remains the stronger independent predictor of pathologic EPE regardless of ERC use.

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直肠内线圈的使用对前列腺磁共振成像中前列腺外扩展检测的影响：回顾性单中心研究

原理和目的：术前基于mpmri的前列腺癌前列腺外展（EPE）准确检测对手术计划和患者预后至关重要。本研究旨在评估使用直肠内线圈（ERC）对mpMRI检测EPE诊断性能的影响。材料和方法：本回顾性研究前瞻性收集数据，包括2007年至2024年间因前列腺癌接受mpMRI和根治性前列腺切除术的参与者。参与者根据ERC在mpMRI上的使用情况分为：无ERC和有ERC的MRI。采用手术病理报告，在全载组织病理学上确定病理性EPE患者。一位放射科医生使用内部（国家癌症研究所[NCI]） EPE分级系统评估mpMRI。进行Logistic回归（LR）分析以确定病理性EPE的重要预测因素，包括ERC使用和NCI EPE分级。结果：纳入934名男性（中位年龄：62岁[IQR = 57-67]）。对于NCI EPE分级≥1的患者，ERC MRI组（n = 612）的NPV（91%[320/353]对83% [166/200]，p = 0.01）和敏感性（75%[101/134]对62% [56/90]，p = 0.04）均高于非ERC组（n = 322）。对于NCI EPE分级为3级的患者，ERC MRI组NPV （83% [452/546] vs. 75% [221/294], p = 0.01）和准确率（80% [492/612]vs. 74% [238/322], p = 0.03）较高。在多变量LR中，较高的NCI EPE等级是病理性EPE的强大独立预测因子，与ERC使用无关(NCI EPE 2级与ERC：优势比[OR] = 2.01, p = 0.04；结论：ERC提高了不同NCI EPE阈值下mpMRI检测EPE的灵敏度、NPV和准确性。无论是否使用ERC， NCI EPE分级系统仍然是病理性EPE的较强独立预测指标。

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

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.