Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging Journal Article

Authors: Akin, O.; Sala, E.; Moskowitz, C. S.; Kuroiwa, K.; Ishill, N. M.; Pucar, D.; Scardino, P. T.; Hricak, H.
Article Title: Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging
Abstract: Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard and to assess MR imaging features of these cancers. Matherials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and κ statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used. Results: For identification of patients with transition zone cancers sensitivity and specificity were 75% and 87% respectively, for reader 1 and 80% and 78%, respectively for reader 2. Intel-reader agreement was fair. For detection of location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56% and 94%, respectively, for reader 1 and 28% and 93%, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer. Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers. © RSNA, 2006.
Keywords: adult; aged; middle aged; retrospective studies; major clinical study; review; cancer localization; area under the curve; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; neoplasm staging; diagnostic accuracy; sensitivity and specificity; retrospective study; prostate cancer; prostatic neoplasms; prostate; prostatectomy; multivariate logistic regression analysis; area under curve; false positive reactions; signal detection; roc curve; rectum; kappa statistics
Journal Title: Radiology
Volume: 239
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2006-06-01
Start Page: 784
End Page: 792
Language: English
DOI: 10.1148/radiol.2392050949
PUBMED: 16569788
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 98" - "Export Date: 4 June 2012" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Kentaro Kuroiwa
    28 Kuroiwa
  2. Evis Sala
    96 Sala
  3. Peter T Scardino
    622 Scardino
  4. Darko Pucar
    12 Pucar
  5. Chaya S. Moskowitz
    174 Moskowitz
  6. Hedvig Hricak
    335 Hricak
  7. Oguz Akin
    179 Akin
  8. Nicole Marie Leoce
    86 Leoce