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 Journal Article


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"
Altmetric Score
MSK Authors
  1. Jingbo Zhang
    34 Zhang
  2. Hedvig Hricak
    333 Hricak
  3. Amita Dave
    80 Dave
  4. Oguz Akin
    179 Akin