Normal central zone of the prostate and central zone involvement by prostate cancer: Clinical and mr imaging implications Journal Article


Authors: Vargas, H. A.; Akin, O.; Franiel, T.; Goldman, D. A.; Udo, K.; Touijer, K. A.; Reuter, V. E.; Hricak, H.
Article Title: Normal central zone of the prostate and central zone involvement by prostate cancer: Clinical and mr imaging implications
Abstract: Purpose: To describe the anatomic features of the central zone of the prostate on T2-weighted and diffusion-weighted (DW) magnetic resonance (MR) images and evaluate the diagnostic performance of MR imaging in detection of central zone involvement by prostate cancer. Materials and Methods: The institutional review board waived informed consent and approved this retrospective, HIPAA-compliant study of 211 patients who underwent T2-weighted and DW MR imaging of the prostate before radical prostatectomy. Whole-mount step-section pathologic findings were the reference standard. Two radiologists independently recorded the visibility, MR signal intensity, size, and symmetry of the central zone and scored the likelihood of central zone involvement by cancer on T2-weighted MR images and on T2-weighted MR images plus apparent diffusion coefficient (ADC) maps generated from the DW MR images. Descriptive summary statistics were calculated for central zone imaging features. Sensitivity, specificity, and area under the curve were used to evaluate reader performance in detecting central zone involvement. Results: For readers 1 and 2, the central zone was visible, at least partially, in 177 (84%) and 170 (81%) of 211 patients, respectively. The most common imaging appearance of the central zone was symmetric, homogeneous low signal intensity. Cancers involving the central zone had higher prostate-specific antigen values, Gleason scores, and rates of extracapsular extension and seminal vesicle invasion compared with cancers not involving the central zone (P < .05). Area under the curve, sensitivity, and specificity in detecting central zone involvement were 0.70, 0.30, and 0.96 for reader 1 and 0.65, 0.35, and 0.93 for reader 2, and these values did not differ significantly between T2-weighted imaging and T2-weighted imaging plus ADC maps. Conclusion: The central zone was visualized in most patients. Cancers involving the central zone were associated with more aggressive disease than those without central zone involvement. © RSNA, 2012.
Journal Title: Radiology
Volume: 262
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2012-03-01
Start Page: 894
End Page: 902
Language: English
DOI: 10.1148/radiol.11110663
PROVIDER: scopus
PMCID: PMC3285222
PUBMED: 22357889
DOI/URL:
Notes: --- - "Export Date: 2 April 2012" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Abdelkrim Karim Touijer
    190 Touijer
  2. Hedvig Hricak
    333 Hricak
  3. Kazuma Udo
    10 Udo
  4. Victor Reuter
    922 Reuter
  5. Oguz Akin
    179 Akin
  6. Debra Alyssa Goldman
    97 Goldman