Accuracy of multiparametric MR imaging with PI-RADS V2 assessment in detecting infiltration of the neurovascular bundles prior to prostatectomy
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Accuracy of multiparametric MR imaging with PI-RADS V2 assessment in detecting infiltration of the neurovascular bundles prior to prostatectomy. / Sauer, Markus; Weinrich, Julius M; Fraune, Christoph; Salomon, Georg; Tennstedt, Pierre; Adam, Gerhard; Beyersdorff, Dirk.
in: EUR J RADIOL, Jahrgang 98, 01.2018, S. 187-192.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Accuracy of multiparametric MR imaging with PI-RADS V2 assessment in detecting infiltration of the neurovascular bundles prior to prostatectomy
AU - Sauer, Markus
AU - Weinrich, Julius M
AU - Fraune, Christoph
AU - Salomon, Georg
AU - Tennstedt, Pierre
AU - Adam, Gerhard
AU - Beyersdorff, Dirk
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - OBJECTIVES: To evaluate the accuracy of assessment of neurovascular bundle (NVB) infiltration using multiparametric magnetic resonance imaging (mpMRI) and PI-RADS V2 prior to prostatectomy.METHODS: The ethics committee approved this retrospective study with waiver of informed consent. N=198 consecutive patients with biopsy proved cancer underwent standardized mpMRI at 3T prior to surgery. NVB infiltration was assessed for each side (a total of 396). Maximum PI-RADS V2 scores were determined for the posterolateral areas adjacent to the NVBs. Imaging results were correlated with postoperative pathology and standard descriptive statistics were calculated.RESULTS: Overall T-staging sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of mpMRI were 64.4%, 89.2%, 82.4%, 76.2% and 78.3%, respectively. In 396 cases NVB infiltration was predicted with 75.3%, 94.0%, 80.2%, 92.1 % and 89.4 % sensitivity, specificity, PPV, NPV and accuracy, respectively. Analyses of 396 NVB and their adjacent PI-RADS V2 scores with pathology revealed significantly more NVB-infiltrations in suspect scores of 5 and 4 vs. uncertain scores of 3-1 (81/264 vs. 16/132, p=0.0001). Considering scores higher than 3 as a criterion of infiltration demonstrated moderate sensitivity and poor specificity (83.5% and 38.8%, respectively). Interobserver agreement of a second reading of a random sample was good (κ=0.64) for NVB infiltrations and moderate (κ=0.59) for PI-RADS V2.CONCLUSIONS: Assessment of infiltration of the neurovascular bundles using mpMRI has valuable diagnostic performance, yet PI-RADS V2 Scores demonstrate limited eligibility. Combined findings offer crucial information for the planning of prostatectomy.
AB - OBJECTIVES: To evaluate the accuracy of assessment of neurovascular bundle (NVB) infiltration using multiparametric magnetic resonance imaging (mpMRI) and PI-RADS V2 prior to prostatectomy.METHODS: The ethics committee approved this retrospective study with waiver of informed consent. N=198 consecutive patients with biopsy proved cancer underwent standardized mpMRI at 3T prior to surgery. NVB infiltration was assessed for each side (a total of 396). Maximum PI-RADS V2 scores were determined for the posterolateral areas adjacent to the NVBs. Imaging results were correlated with postoperative pathology and standard descriptive statistics were calculated.RESULTS: Overall T-staging sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of mpMRI were 64.4%, 89.2%, 82.4%, 76.2% and 78.3%, respectively. In 396 cases NVB infiltration was predicted with 75.3%, 94.0%, 80.2%, 92.1 % and 89.4 % sensitivity, specificity, PPV, NPV and accuracy, respectively. Analyses of 396 NVB and their adjacent PI-RADS V2 scores with pathology revealed significantly more NVB-infiltrations in suspect scores of 5 and 4 vs. uncertain scores of 3-1 (81/264 vs. 16/132, p=0.0001). Considering scores higher than 3 as a criterion of infiltration demonstrated moderate sensitivity and poor specificity (83.5% and 38.8%, respectively). Interobserver agreement of a second reading of a random sample was good (κ=0.64) for NVB infiltrations and moderate (κ=0.59) for PI-RADS V2.CONCLUSIONS: Assessment of infiltration of the neurovascular bundles using mpMRI has valuable diagnostic performance, yet PI-RADS V2 Scores demonstrate limited eligibility. Combined findings offer crucial information for the planning of prostatectomy.
KW - Journal Article
U2 - 10.1016/j.ejrad.2017.11.019
DO - 10.1016/j.ejrad.2017.11.019
M3 - SCORING: Journal article
C2 - 29279161
VL - 98
SP - 187
EP - 192
JO - EUR J RADIOL
JF - EUR J RADIOL
SN - 0720-048X
ER -