Liang Wang MD, Presenter: Nothing to Disclose

Hedvig Hricak MD, Abstract Co-Author: Nothing to Disclose

Michael W. Kattan PhD, Abstract Co-Author: Nothing to Disclose

Hui-Ni Chen MS, Abstract Co-Author: Nothing to Disclose

Peter T Scardino MD, Abstract Co-Author: Nothing to Disclose

To assess the incremental value of endorectal coil magnetic resonance imaging (erMRI) to the Partin staging nomograms in the prediction of organ-confined prostate cancer (OC).

Preoperative erMRI was performed in 411 patients, in 268 of whom erMRI was combined with MRSI. The MR studies were interpreted prospectively by 10 MR radiologists. Based on the official MR reports, 5-point scores were assigned retrospectively for the risks of extracapsular extension, seminal vesicle invasion, and lymph node metastasis. The likelihood of OC on Partin was calculated based on PSA, Gleason grade and clinical staging. Step-section histopathology was the standard of reference. The predictive value of erMRI was assessed using ROC analysis adjusted for multiple observations per patient and a mixed-effects ordinal regression model for stratifications by reader experience, patient risk for cancer spread outside the prostate, and MR tests performed.

In the prediction of OC, the addition of erMRI significantly improved the Partin nomogram (AUC: 0.7769 for Partin versus 0.8327 for erMRI plus Partin; 95% CI: 0.7947, 0.8834); out of the three patient-risk subgroups (low-, intermediate-, and high-risk), the improvement was the greatest in the low-risk subgroup (AUC: 0.5876 for Partin versus 0.7443 for erMRI plus Partin; 95% CI: 0.6462, 0.8525). The addition of MRSI to erMRI resulted in further significant improvement to the Partin beyond the improvement offered by erMRI alone (AUC: 0.7895 for Partin versus 0.8518 for erMRI/MRSI plus Partin 95% CI: 0.8023, 0.9132).

In the prediction of OC, erMRI adds significant incremental value to the Partin, and the addition of MRSI to erMRI significantly increases this incremental value.

Wang, L, Hricak, H, Kattan, M, Chen, H, Scardino, P, Prediction of Prostate Cancer Organ-confined Disease: The Incremental Value of Endorectal Coil Magnetic Resonance Imaging to Partin Staging Nomograms (2001 version).  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411867.html