Prediction of prostate cancer recurrence using magnetic resonance imaging and molecular profiles Journal Article


Authors: Shukla-Dave, A.; Hricak, H.; Ishill, N.; Moskowitz, C. S.; Drobnjak, M.; Reuter, V. E.; Zakian, K. L.; Scardino, P. T.; Cordon-Cardo, C.
Article Title: Prediction of prostate cancer recurrence using magnetic resonance imaging and molecular profiles
Abstract: Purpose: To evaluate whether pretreatment magnetic resonance imaging (MRI)/MR spectroscopic imaging (MRSI) findings and molecular markers in surgical specimens correlate with each other and with pretreatment clinical variables (biopsy Gleason score, clinical stage, and prostate-specific antigen level) and whether they contribute incremental value in predicting prostate cancer recurrence. Experimental Design: Eighty-eight prostate cancer patients underwent MRI/MRSI before radical prostatectomy; imaging findings were scored on a scale of 1 to 7 (no tumor seen-lymph node metastasis). Ki-67, phospho-Akt, and androgen receptor expression in surgical specimens were assessed by immunohistochemistry. To examine correlations between markers and imaging scores, Spearman's correlation was used. To test whether markers and imaging scores differed by clinical stage or Gleason score, Wilcoxon's rank sum test was used. To examine time to recurrence, the methods of Kaplan-Meier were used. Cox proportional hazards models were built and their concordance indices (C-indices) were calculated to evaluate prediction of recurrence. Results: All markers correlated moderately strongly with MRI/MRSI score (all correlation coefficients >0.5). Markers and MRI/MRSI score were strongly associated with clinical stage and biopsy Gleason score (P < 0.01 for all). At last follow-up, 27 patients had recurrence. C-indices for MRI/MRSI score and all markers were associated with time to recurrence and ranged from 0.78 to 0.89. A Cox model combining all clinical predictors had a C-index of 0.89; the C-index increased to 0.95 when MRI/MRSI score was added and to 0.97 when markers were also added. Conclusions: MRI/MRSI findings and molecular markers correlated well with each other and contributed incremental value to clinical variables in predicting prostate cancer recurrence. © 2009 American Association for Cancer Research.
Keywords: immunohistochemistry; protein kinase b; adult; human tissue; aged; middle aged; major clinical study; cancer recurrence; nuclear magnetic resonance imaging; magnetic resonance imaging; ki 67 antigen; ki-67 antigen; prostate specific antigen; neoplasm recurrence, local; proportional hazards models; tumor markers, biological; prediction; prostate cancer; kaplan-meiers estimate; gleason score; prostatic neoplasms; molecular marker; correlation analysis; correlation coefficient; statistical analysis; severity of illness index; enzyme phosphorylation; proto-oncogene proteins c-akt; predictive value of tests; magnetic resonance spectroscopy; nuclear magnetic resonance spectroscopy; phosphoproteins; predictor variable; androgen receptor; receptors, androgen
Journal Title: Clinical Cancer Research
Volume: 15
Issue: 11
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2009-06-01
Start Page: 3842
End Page: 3849
Language: English
DOI: 10.1158/1078-0432.ccr-08-2453
PUBMED: 19435838
PROVIDER: scopus
PMCID: PMC2811524
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: CCREF" - "Source: Scopus"
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MSK Authors
  1. Peter T Scardino
    621 Scardino
  2. Chaya S. Moskowitz
    172 Moskowitz
  3. Hedvig Hricak
    330 Hricak
  4. Amita Dave
    77 Dave
  5. Kristen L Zakian
    74 Zakian
  6. Victor Reuter
    900 Reuter
  7. Nicole Marie Leoce
    86 Leoce