Authors: | Wassberg, C.; Akin, O.; Vargas, H. A.; Shukla-Dave, A.; Zhang, J.; Hricak, H. |
Article Title: | The incremental value of contrast-enhanced MRI in the detection of biopsy-proven local recurrence of prostate cancer after radical prostatectomy: Effect of reader experience |
Abstract: | OBJECTIVE. The purpose of this study is to retrospectively assess the incremental value of contrast-enhanced MRI (CE-MRI) to T2-weighted MRI in the detection of postsurgical local recurrence of prostate cancer by readers of different experience levels, using biopsy as the reference standard. MATERIALS AND METHODS. Fifty-two men with biochemical recurrence after prostatectomy underwent 1.5-T endorectal MRI with multiphase contrast-enhanced imaging and had biopsy within 3 months of MRI. Two radiologists (reader 1 had 1 year and reader 2 had 6 years of experience) independently reviewed each MRI study and classified the likelihood of recurrent cancer on a 5-point scale. Areas under receiver operating characteristic curves (A z) were calculated to assess readers' diagnostic performance with T2-weighted MRI alone and combined with CE-MRI. Interobserver agreement was assessed using Cohen kappa statistics. RESULTS. Thirty-three patients (63%) had biopsy-proven local recurrence of prostate cancer. With the addition of CE-MRI to T2-weighted imaging, the A z for cancer detection increased significantly for reader 1 (0.77 vs 0.85; p = 0.0435) but not for reader 2 (0.86 vs 0.88; p = 0.7294). The use of CE-MRI improved interobserver agreement from fair (κ = 0.39) to moderate (κ = 0.58). CONCLUSION. CE-MRI increased interobserver agreement and offered incremental value to T2-weighted MRI in the detection of locally recurrent prostate cancer for the relatively inexperienced reader. © American Roentgen Ray Society. |
Keywords: | adult; clinical article; controlled study; aged; retrospective studies; histopathology; cancer recurrence; nuclear magnetic resonance imaging; recurrent cancer; magnetic resonance imaging; diagnostic accuracy; sensitivity and specificity; prostate specific antigen; neoplasm recurrence, local; retrospective study; biopsy; prostate cancer; gleason score; prostatic neoplasms; clinical competence; prostatectomy; contrast enhancement; prostate biopsy; contrast media; area under curve; contrast-enhanced mri; gadolinium pentetate; gadolinium dtpa; biochemical recurrence; mri; predictive value; roc curve; receiver operating characteristic; diagnostic test accuracy study; locally recurrent prostate cancer |
Journal Title: | American Journal of Roentgenology |
Volume: | 199 |
Issue: | 2 |
ISSN: | 0361-803X |
Publisher: | American Roentgen Ray Society |
Date Published: | 2012-01-01 |
Start Page: | 360 |
End Page: | 366 |
Language: | English |
DOI: | 10.2214/ajr.11.6923 |
PROVIDER: | scopus |
PUBMED: | 22826397 |
PMCID: | PMC3462075 |
DOI/URL: | |
Notes: | --- - "Export Date: 4 September 2012" - "CODEN: AJROA" - "Source: Scopus" |