Abstract
INTRODUCTION: Increasing evidence has supported the use of multiparametric magnetic resonance imaging (mpMRI) for the detection of prostate cancer. However, its role in selecting patients clinically suitable for active surveillance (AS) is still in development. We aimed to find relevant mpMRI features that might be helpful for refinement of the selection of low-risk prostate cancer patients for AS. We also evaluated the interobserver variability in reporting prostate mpMRI features.
PATIENTS AND METHODS: From 2008 to 2012, 135 patients were selected for AS using Epstein criteria. Baseline mpMRI studies were performed within 3 months of recruitment and reviewed by 2 radiologists who were unaware of the patients' outcomes. The radiologists recorded the mpMRI features using the Prostate Imaging Reporting and Data System (PI-RADS) guidelines. The overall likelihood of the presence of significant prostate cancer was also determined using the Likert and PI-RADS, version 2 (v2), scores. Univariate and multivariate analyses, receiver operating characteristic curves, and Kaplan-Meier survival curves were calculated for the mpMRI features with respect to patient withdrawal from the AS program and failure-free survival (FFS). The interobserver agreement was also evaluated.
RESULTS: At a median follow-up time of 31 months (range, 6-80 months), 84 patients (62.2%) were participating in the AS program. In 2 multivariate models, the variables significantly associated with outcomes for both readers were the index lesion size (hazard ratio [HR], 2.34 and 3.13, respectively) and overall PI-RADS, v2, score (HR, 2.51 and 3.21, respectively). The interobserver agreement was higher for the overall Likert and PI-RADS, v2, scores.
CONCLUSION: Overall, the PI-RADS, v2, score and index lesion size were strongly associated with FFS. Overall, the Likert and PI-RADS, v2, scoring systems have been confirmed to be useful, although further improvements are needed.
| Original language | English |
|---|---|
| Pages (from-to) | 155-163.e6 |
| Journal | Clinical Genitourinary Cancer |
| Volume | 16 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2018 |
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Keywords
- Aged
- Humans
- Kaplan-Meier Estimate
- Magnetic Resonance Imaging/methods
- Male
- Middle Aged
- Observer Variation
- Patient Selection
- Prostatic Neoplasms/diagnostic imaging
- ROC Curve
- Sensitivity and Specificity
- Watchful Waiting
Cite this
Baseline Multiparametric MRI for Selection of Prostate Cancer Patients Suitable for Active Surveillance : Which Features Matter? / Sanguedolce, Francesco; Petralia, Giuseppe; Sokhi, Heminder; Tagliabue, Elena; Anyamene, Nicola; Hellawell, Giles; Padhani, Anwar R.
In: Clinical Genitourinary Cancer, Vol. 16, No. 2, 04.2018, p. 155-163.e6.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Baseline Multiparametric MRI for Selection of Prostate Cancer Patients Suitable for Active Surveillance
T2 - Which Features Matter?
AU - Sanguedolce, Francesco
AU - Petralia, Giuseppe
AU - Sokhi, Heminder
AU - Tagliabue, Elena
AU - Anyamene, Nicola
AU - Hellawell, Giles
AU - Padhani, Anwar R
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - INTRODUCTION: Increasing evidence has supported the use of multiparametric magnetic resonance imaging (mpMRI) for the detection of prostate cancer. However, its role in selecting patients clinically suitable for active surveillance (AS) is still in development. We aimed to find relevant mpMRI features that might be helpful for refinement of the selection of low-risk prostate cancer patients for AS. We also evaluated the interobserver variability in reporting prostate mpMRI features.PATIENTS AND METHODS: From 2008 to 2012, 135 patients were selected for AS using Epstein criteria. Baseline mpMRI studies were performed within 3 months of recruitment and reviewed by 2 radiologists who were unaware of the patients' outcomes. The radiologists recorded the mpMRI features using the Prostate Imaging Reporting and Data System (PI-RADS) guidelines. The overall likelihood of the presence of significant prostate cancer was also determined using the Likert and PI-RADS, version 2 (v2), scores. Univariate and multivariate analyses, receiver operating characteristic curves, and Kaplan-Meier survival curves were calculated for the mpMRI features with respect to patient withdrawal from the AS program and failure-free survival (FFS). The interobserver agreement was also evaluated.RESULTS: At a median follow-up time of 31 months (range, 6-80 months), 84 patients (62.2%) were participating in the AS program. In 2 multivariate models, the variables significantly associated with outcomes for both readers were the index lesion size (hazard ratio [HR], 2.34 and 3.13, respectively) and overall PI-RADS, v2, score (HR, 2.51 and 3.21, respectively). The interobserver agreement was higher for the overall Likert and PI-RADS, v2, scores.CONCLUSION: Overall, the PI-RADS, v2, score and index lesion size were strongly associated with FFS. Overall, the Likert and PI-RADS, v2, scoring systems have been confirmed to be useful, although further improvements are needed.
AB - INTRODUCTION: Increasing evidence has supported the use of multiparametric magnetic resonance imaging (mpMRI) for the detection of prostate cancer. However, its role in selecting patients clinically suitable for active surveillance (AS) is still in development. We aimed to find relevant mpMRI features that might be helpful for refinement of the selection of low-risk prostate cancer patients for AS. We also evaluated the interobserver variability in reporting prostate mpMRI features.PATIENTS AND METHODS: From 2008 to 2012, 135 patients were selected for AS using Epstein criteria. Baseline mpMRI studies were performed within 3 months of recruitment and reviewed by 2 radiologists who were unaware of the patients' outcomes. The radiologists recorded the mpMRI features using the Prostate Imaging Reporting and Data System (PI-RADS) guidelines. The overall likelihood of the presence of significant prostate cancer was also determined using the Likert and PI-RADS, version 2 (v2), scores. Univariate and multivariate analyses, receiver operating characteristic curves, and Kaplan-Meier survival curves were calculated for the mpMRI features with respect to patient withdrawal from the AS program and failure-free survival (FFS). The interobserver agreement was also evaluated.RESULTS: At a median follow-up time of 31 months (range, 6-80 months), 84 patients (62.2%) were participating in the AS program. In 2 multivariate models, the variables significantly associated with outcomes for both readers were the index lesion size (hazard ratio [HR], 2.34 and 3.13, respectively) and overall PI-RADS, v2, score (HR, 2.51 and 3.21, respectively). The interobserver agreement was higher for the overall Likert and PI-RADS, v2, scores.CONCLUSION: Overall, the PI-RADS, v2, score and index lesion size were strongly associated with FFS. Overall, the Likert and PI-RADS, v2, scoring systems have been confirmed to be useful, although further improvements are needed.
KW - Aged
KW - Humans
KW - Kaplan-Meier Estimate
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Observer Variation
KW - Patient Selection
KW - Prostatic Neoplasms/diagnostic imaging
KW - ROC Curve
KW - Sensitivity and Specificity
KW - Watchful Waiting
U2 - 10.1016/j.clgc.2017.10.020
DO - 10.1016/j.clgc.2017.10.020
M3 - Article
C2 - 29198639
VL - 16
SP - 155-163.e6
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
SN - 1558-7673
IS - 2
ER -