HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2451061502v1 245/1/176    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bloch, B. N. Articles by Rofsky, N. M. Search for Related Content PubMed PubMed Citation Articles by Bloch, B. N. Articles by Rofsky, N. M.

Prostate Cancer: Accurate Determination of Extracapsular Extension with High-Spatial-Resolution Dynamic Contrast-enhanced and T2-weighted MR Imaging—Initial Results¹

¹ From the Departments of Radiology (B.N.B., T.H.H., S.J.), Urology (C.K.), and Clinical Pathology (M.S., A.H.), Vienna General Hospital, Medical University of Vienna, Vienna, Austria; Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel (E.F., H.D.); and Department of Radiology (B.N.B., R.E.L., N.M.R.), Division of General Medicine and Primary Care (L.N.), Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, E/Dana 705b, Boston, MA 02215. From the 2002 RSNA Annual Meeting. Received September 8, 2006; revision requested November 9; revision received January 15, 2007; final version accepted March 1. Supported in part by grants of the Jubileumsfonds of the Austrian National Bank, Vienna, Austria (project no. 9570); Medrad, Indianola, Pa; Schering, Berlin, Germany; and Lord David Alliance, CBE, London, England. Address correspondence to B.N.B. (e-mail: nbloch{at}bidmc.harvard.edu).

Purpose: To prospectively compare the sensitivity and specificity of high-spatial-resolution dynamic contrast material–enhanced magnetic resonance (MR) imaging with those of high-spatial-resolution T2-weighted MR imaging, performed with an endorectal coil (ERC), for assessment of extracapsular extension (ECE) and staging in patients with prostate cancer, with histopathologic findings as reference.

Materials and Methods: The study was approved by the institutional internal review board; a signed informed consent was obtained. MR imaging of the prostate at 1.5 T was performed with combined surface coils and ERCs in 32 patients (mean age, 65 years; range, 42–78 years) before radical prostatectomy. High-spatial-resolution T2-weighted fast spin-echo and high-spatial-resolution dynamic contrast-enhanced three-dimensional gradient-echo images were acquired with gadopentetate dimeglumine. Dynamic contrast-enhanced MR images were analyzed with a computer-generated color-coded scheme. Two experienced readers independently assessed ECE and tumor stage. MR imaging–based staging results were compared with histopathologic results. For the prediction of ECE, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Staging accuracy was determined with the area under the receiver operating characteristic curve (AUC) by using the Wilcoxon-Mann-Whitney index of diagnostic accuracy.

Results: The mean sensitivity, specificity, PPV, and NPV for assessment of ECE with the combined data sets for both readers were 86%, 95%, 90%, and 93%, respectively. The sensitivity of MR images for determination of ECE was significantly improved for both readers (>25%) with combined data sets compared with T2-weighted MR images alone. The combined data sets had a mean overall staging accuracy for both readers of 95%, as determined with AUC. Staging results for both readers were significantly improved (P < .05) with the combined data sets compared with T2-weighted MR images alone.

Conclusion: The combination of high-spatial-resolution dynamic contrast-enhanced MR imaging and T2-weighted MR imaging yields improved assessment of ECE and better results for prostate cancer staging compared with either technique independently.

© RSNA, 2007