Diagnosis of extracapsular extension of prostate cancer on prostate MRI: Impact of second-opinion readings by subspecialized genitourinary oncologic radiologists Journal Article


Authors: Wibmer, A.; Vargas, H. A.; Donahue, T. F.; Zheng, J.; Moskowitz, C.; Eastham, J.; Sala, E.; Hricak, H.
Article Title: Diagnosis of extracapsular extension of prostate cancer on prostate MRI: Impact of second-opinion readings by subspecialized genitourinary oncologic radiologists
Abstract: OBJECTIVE. The purpose of this article is to investigate the added value of second-opinion evaluation of prostate MRI by subspecialized genitourinary oncologic radiologists for the assessment of extracapsular extension (ECE) of prostate cancer. MATERIALS AND METHODS. We performed a retrospective evaluation of initial and second-opinion radiology reports of 76 patients who underwent MRI of the prostate before prostatectomy for histologically proven prostate cancer. Initial outside reports and second-opinion reports were unpaired and reviewed in random order by a urologist who was blinded to patients' clinical details and histopathologic data. Histopathologic analysis of the prostatectomy specimen served as the reference standard. RESULTS. Among cases with diagnostic-quality images available (71/76; 93%), disagreement between the initial report and the second-opinion report was observed in 30% of cases (21/71; κ = 0.35); in 18 of these 21 cases (86%), histopathologic analysis proved that the second-opinion report was correct. The second-opinion interpretations had statistically significantly higher sensitivity (66% vs 24%; p < 0.0001) than did the initial reports, whereas there was no statistically significant difference in specificity (87% vs 93%; p = 0.317). On ROC curve analysis, the second-opinion reports yielded a statistically significantly higher AUC for the detection of ECE (0.80 vs 0.65; p = 0.004). CONCLUSION. The reinterpretation of prostate MRI examinations by subspecialized genitourinary oncologic radiologists improved the detection of ECE of prostate cancer.
Keywords: adult; cancer chemotherapy; controlled study; aged; major clinical study; histopathology; area under the curve; cancer staging; nuclear magnetic resonance imaging; antineoplastic agent; cancer grading; diagnostic accuracy; sensitivity and specificity; diagnostic imaging; retrospective study; urogenital tract cancer; risk assessment; cancer hormone therapy; prostate cancer; radiologist; prostatectomy; image quality; mri; receiver operating characteristic; digital rectal examination; diagnostic test accuracy study; urologist; human; male; priority journal; article; extracapsular tumor extension of prostate cancer; second-opinion reinterpretation; subspecialization; second-opinion readings
Journal Title: American Journal of Roentgenology
Volume: 205
Issue: 1
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2015-07-01
Start Page: W73
End Page: W78
Language: English
DOI: 10.2214/ajr.14.13600
PROVIDER: scopus
PUBMED: 26102421
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Junting Zheng
    133 Zheng
  2. Evis Sala
    95 Sala
  3. Chaya S. Moskowitz
    173 Moskowitz
  4. Hedvig Hricak
    333 Hricak
  5. James Eastham
    427 Eastham
  6. Timothy Francis Donahue
    18 Donahue
  7. Andreas Georg Wibmer
    18 Wibmer