Prediction of seminal vesicle invasion in prostate cancer: Incremental value of adding endorectal MR imaging to the Kattan nomogram Journal Article


Authors: Wang, L.; Hricak, H.; Kattan, M. W.; Chen, H. N.; Kuroiwa, K.; Eisenberg, H. F.; Scardino, P. T.
Article Title: Prediction of seminal vesicle invasion in prostate cancer: Incremental value of adding endorectal MR imaging to the Kattan nomogram
Abstract: Purpose: To retrospectively determine whether endorectal magnetic resonance (MR) imaging findings contribute incremental value to the Kattan nomogram for predicting seminal vesicle invasion (SVI) in patients with prostate cancer. Materials and Methods: The institutional review board issued a waiver of authorization, which included a waiver of informed consent, for this HIPAA-compliant study. From October 2000 through January 2005, 573 patients (mean age, 58.3 years; age range, 36-86 years) underwent endorectal MR imaging before prostate cancer surgery. The endorectal MR imaging results had been prospectively interpreted by seven radiologists, and the likelihood of SVI was retrospectively scored on the basis of radiologists' written reports. MR imaging findings, individual clinical variables (serum prostate-specific antigen [PSA] level, Gleason grade, clinical stage, greatest percentage of cancer in all biopsy cores, percentage of positive cores in all biopsy cores, and perineural invasion), and the Kattan nomogram were evaluated with respect to SVI prediction; surgical pathologic analysis was used as the reference standard. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: At pathologic analysis, 28 (4.9%) of 573 patients had SVI. At univariate analysis, endorectal MR imaging results and all clinical variables except the percentage of positive biopsy cores were significantly associated with SVI (P < .02); endorectal MR imaging (0.76) had a larger area under the ROC curve (AUC) than any clinical variable (0.62-0.73). At multivariate analysis, endorectal MR imaging results, Gleason grade, PSA level, and the percentage of cancer in all biopsy cores were significantly associated with SVI (P < .02). The Kattan nomogram plus endorectal MR imaging (0.87) had a significantly larger (P < .05) AUC than either endorectal MR imaging alone (0.76) or the Kattan nomogram alone (0.80). Conclusion: The addition of endorectal MR imaging contributes significant incremental value to the Kattan nomogram for predicting SVI. © RSNA, 2006.
Keywords: adult; human tissue; aged; aged, 80 and over; middle aged; major clinical study; review; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm staging; sensitivity and specificity; prostate specific antigen; reproducibility of results; image analysis; image interpretation, computer-assisted; tumor biopsy; diagnostic imaging; retrospective study; prediction; prostate cancer; cancer invasion; gleason score; prostatic neoplasms; standard; evaluation; image enhancement; scoring system; multivariate analysis; neoplasm invasiveness; perineurium; image processing; logistic regression analysis; nomogram; image reconstruction; health status indicators; receiver operating characteristic; rectum; seminal vesicles; endorectal magnetic resonance imaging; apparatus; kattan nomogram; seminal vesicle disease
Journal Title: Radiology
Volume: 242
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2007-01-01
Start Page: 182
End Page: 188
Language: English
DOI: 10.1148/radiol.2421051254
PUBMED: 17090712
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 42" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Kentaro Kuroiwa
    28 Kuroiwa
  2. Peter T Scardino
    647 Scardino
  3. Hedvig Hricak
    384 Hricak
  4. Liang Wang
    35 Wang
  5. Hui-Ni Chen
    17 Chen