Impact of multiparametric magnetic resonance imaging on risk group assessment of patients with prostate cancer addressed to external beam radiation therapy. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Pullini, Serena; Signor, Marco Andrea; Pancot, Martina; Zuiani, Chiara; Bazzocchi, Massimo; Fongione, Sandro; Girometti, Rossano
• Is Part Of: European journal of radiology. Volume 85:Issue 4(2016)
• Page Start: 764
• Page End: 770
• Publication Date: 2016-04
• Subjects: Pca prostate cancer -- mpMRI multiparametric magnetic resonance imaging -- EBRT external beam radiation therapy -- DRE digital rectal examination -- TRUS transrectal ultrasonography -- PSA prostate-specific antigen -- GS Gleason score -- NCCN National comprehensive cancer network -- DWI diffusion-weighted Imaging -- DCE dynamic contrast-enhanced Imaging -- c-RA clinical risk assessment -- mpMRI-RA mpMRI-based risk assessment -- PI-RADS Prostate imaging reporting and data system -- ESUR European society of urogenital radiology -- TNM tumour node metastasis -- SPAIR spectrally adiabatic inversion recovery -- ECE extra-capsular extension -- SVI seminal vesicles invasion -- ADT androgen deprivation therapy; Magnetic Resonance Imaging -- Prostatic Neoplasm -- Risk stratification -- Radiotherapy -- Patient Care Planning; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2016.01.008
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To investigate the impact of multiparametric magnetic resonance imaging (mpMRI) on risk group assessment of patients with prostate cancer (PCa) initially addressed to external beam radiation therapy (EBRT). Materials and methods: We prospectively performed mpMRI (3.0Tsystem) in 44 patients addressed to EBRT, using a multiparametric protocol (high-resolution multiplanar T2-weighted, diffusion-weighted and dynamic contrast-enhanced imaging). Risk group was assessed in accordance with the National comprehensive cancer network (NCCN) categories, by combining prostate-specific-antigen level, Gleason score and the T-stage as established by digital rectal examination (clinical risk assessment; c-RA) versus mpMRI (mpMRI-risk assessment; mpMRI-RA). The agreement between c-RA and mpMRI-RA was investigated using Cohen's kappa. Results: Patients were included in very low/low risk, intermediate risk, high risk, very high risk and metastatic NCCN categories in 10 (22.7%), 18 (40.9%), 15 (34.1%), 1 (2.3%) and 0 cases using c-RA vs. 8 (18.2%), 14 (31.8%), 14 (31.8%), 4 (9.1%) and 4 (9.1%) cases using mpMRI-RA, respectively, with only moderate agreement ( k = 0.43). mpMRI-RA determined risk downgrading in 2/44 patients (4.5%), and risk upgrading in 16/44 patients (36.3%). After mpMRI, EBRT remained indicated in all patients. Conclusion: mpMRI changed clinical risk stratification in about 41% of patients with PCa, with potential impact on EBRT planning.