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DOI: 10.1148/radiol.2301021562
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Prostate Cancer Localization with Endorectal MR Imaging and MR Spectroscopic Imaging: Effect of Clinical Data on Reader Accuracy1

Rajpal Dhingsa, MD, Aliya Qayyum, MD, Fergus V. Coakley, MD, Ying Lu, PhD, Kirk D. Jones, MD, Mark G. Swanson, PhD, Peter R. Carroll, MD, Hedvig Hricak, MD, PhD and John Kurhanewicz, PhD

1 From the Departments of Radiology (R.D., A.Q., F.V.C., J.K., M.G.S., Y.L.), Pathology (K.D.J.), and Urology (P.R.C.), University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628; and Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York (H.H.). Received November 25, 2002; revision requested January 28, 2003; final revision received May 28; accepted June 12. Supported by NIH grant IRGICA76423–0IRI. Address correspondence to A.Q. (e-mail: aliya.qayyum@radiology.ucsf.edu)



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  		Figure 1. Transverse T2-weighted MR image (5,000/96 [effective]) obtained in a 49-year-old man with a PSA level of 4.5 ng/mL and positive finding after transrectal biopsy, which indicated a Gleason grade 6 tumor at the right apex. Image shows a tumor focus (arrow) at the right apex, which was only identified by both readers after clinical data were made available.

 


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  		Figure 2. Transverse T2-weighted MR image (5,000/96 [effective]) obtained in a 66-year-old man with a PSA level of 4.8 ng/mL and positive finding after transrectal biopsy, which indicated a Gleason grade 6 tumor at the left mid-gland. Image shows a false-positive tumor focus (arrow) at the left mid-gland, which was only identified by both readers after clinical data were made available.

 


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  		Figure 3. Graph shows AFROC curves of interpretation of MR images and MR spectroscopic images with and without clinical data. AFROC analysis plots the fraction of nodules with true-positive ratings (v) against the probability of a false-positive image (P[FPI]). The area under the curve in AFROC analysis is a measure of overall test accuracy that combines true-positive and false-positive results and level of confidence, and it can be considered to represent the probability that the first tumor detected in a patient is a true-positive rather than a false-positive result. W = with; W/O = without.

 




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