Endorectal MR imaging before salvage prostatectomy: Tumor localization and staging Journal Article


Authors: Sala, E.; Eberhardt, S. C.; Akin, O.; Moskowitz, C. S.; Onyebuchi, C. N.; Kuroiwa, K.; Ishill, N.; Zelefsky, M. J.; Eastham, J. A.; Hricak, H.
Article Title: Endorectal MR imaging before salvage prostatectomy: Tumor localization and staging
Abstract: Purpose: To evaluate retrospectively the accuracy of endorectal magnetic resonance (MR) imaging for the depiction of tumor, extracapsular extension (ECE), and seminal vesicle invasion (SVI) before salvage prostatectomy in patients with locally recurrent prostate cancer after radiation therapy, by using pathologic analysis as the reference standard. Materials and Methods: The Institutional Review Board granted exempt status for this HIPAA-compliant study, with a waiver of informed consent. Forty-five consecutive patients (age range, 43-76 years) were identified who underwent salvage radical prostatectomy for prostate cancer at Memorial Sloan-Kettering Cancer Center between December 1, 1998, and October 31, 2004 and who underwent endorectal MR imaging prior to surgery. Tumor localization and determination of local stage with MR imaging were performed independently by two radiologists. Interpretations were compared to pathologic findings from surgical specimens. Interrater variability was estimated with the κ statistic. Areas under the receiver operating characteristic curve (AUCs) were used to assess the accuracy of endorectal MR imaging in tumor detection and determination of ECE and SVI. Results: Findings of histologic examination showed that tumor was present in all patients. For tumor detection, the AUC value for reader 1 was 0.75 (95% confidence interval [CI]: 0.67, 0.84), whereas the AUC values for for reader 2 was 0.61 (95% CI: 0.52, 0.71). The AUC values for prediction of ECE were 0.87 (95% CI: 0.80, 0.94) for reader 1 and 0.76 (95% CI: 0.67, 0.85) for reader 2. The AUC values for prediction of SVI were 0.76 (95% CI: 0.62, 0.90) for reader 1 and 0.70 (95% CI: 0.56, 0.85) for reader 2. For all variables, the κ statistics used to assess interrater agreement between readers were fair (0.45, 0.52, and 0.47 for tumor location, ECE, and SVI, respectively). Conclusion: Endorectal MR imaging following radiation therapy can help identify tumor sites and depict ECE and SVI with reasonable accuracy in patients with recurrent prostate cancer. © RSNA, 2006.
Keywords: adult; clinical article; aged; middle aged; retrospective studies; histopathology; salvage therapy; area under the curve; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm staging; diagnostic accuracy; sensitivity and specificity; tumor localization; neoplasm recurrence, local; image analysis; diagnostic imaging; prostate cancer; cancer invasion; prostatic neoplasms; prostatectomy; area under curve; cross-sectional studies; seminal vesicle; image processing, computer-assisted; receiver operating characteristic; rectum; seminal vesicles
Journal Title: Radiology
Volume: 238
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2006-01-01
Start Page: 176
End Page: 183
Language: English
DOI: 10.1148/radiol.2381052345
PUBMED: 16373766
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 49" - "Export Date: 4 June 2012" - "CODEN: RADLA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Kentaro Kuroiwa
    28 Kuroiwa
  2. Evis Sala
    95 Sala
  3. Michael J Zelefsky
    624 Zelefsky
  4. Chaya S. Moskowitz
    173 Moskowitz
  5. Hedvig Hricak
    333 Hricak
  6. James Eastham
    427 Eastham
  7. Oguz Akin
    179 Akin
  8. Nicole Marie Leoce
    86 Leoce