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Prostate Cancer: Detection of Extracapsular Extension by Genitourinary and General Body Radiologists at MR Imaging¹

¹ From the Departments of Urology (M.M., M.W.K., P.T.S.) and Radiology (H.H., L.W., H.N.C.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021. Received August 6, 2003; revision requested September 18; revision received December 19; accepted January 13, 2004. Supported by National Institutes of Health grant R01 CA76423. Address correspondence to H.H. (e-mail: muellnea@mskcc.org).

View larger version (44K): [in a new window]   Figure 1. Graph shows ROC curves of univariate analysis results for all predictors of ECE. Predictors analyzed as continuous variables are indicated (*). Gleason score was categorized as 3 + 2 and 3 + 3 versus 3 + 4, 4 + 3, 3 + 5, 4 + 4, 4 + 5, and 5 + 5. Clinical stage of tumor was categorized according to TNM classifications as T1c versus T2a, T2b, and T2c. Diagonal line indicates area under ROC curve of 0.500. General MRI = endorectal MR imaging findings for general body radiologist group, % Ca = greatest percentage of cancer in all core biopsy specimens, GU MRI = endorectal MR imaging findings for genitourinary radiologist group, % of Pos Cores = percentage of cancer-positive core specimens in all core biopsy specimens.

View larger version (34K): [in a new window]   Figure 2a. Graphs show comparison of ROC curves for detection of ECE, with base model without and with endorectal MR imaging findings. Base model included the following variables: PSA level, Gleason score, greatest percentage of cancer in all core biopsy specimens, percentage of cancer-positive core specimens in all core biopsy specimens, presence of PNI, and clinical stage of tumor. Base model with endorectal MR imaging findings included MR imaging findings with all other variables. Predicted probability was calculated with jackknife method. Diagonal line indicates area under ROC curve of 0.500. (a) Graph shows ROC curves for genitourinary radiologist group. (b) Graph shows ROC curves for general body radiologist group.

View larger version (38K): [in a new window]   Figure 2b. Graphs show comparison of ROC curves for detection of ECE, with base model without and with endorectal MR imaging findings. Base model included the following variables: PSA level, Gleason score, greatest percentage of cancer in all core biopsy specimens, percentage of cancer-positive core specimens in all core biopsy specimens, presence of PNI, and clinical stage of tumor. Base model with endorectal MR imaging findings included MR imaging findings with all other variables. Predicted probability was calculated with jackknife method. Diagonal line indicates area under ROC curve of 0.500. (a) Graph shows ROC curves for genitourinary radiologist group. (b) Graph shows ROC curves for general body radiologist group.