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The role of T2-weighted images in assessing the grade of extraprostatic extension of the prostate carcinoma

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Abstract

Purpose

Extraprostatic extension (EPE) is an unfavorable prognostic factor and the grade of EPE is also shown to be correlated with the prognosis of prostate cancer. The current study assessed the value of prostate magnetic resonance imaging (MRI) in measuring the radial distance (RD) of EPE and the role of T2 WI signs in predicting the grade of EPE.

Materials and methods

A total of 110 patients who underwent prostate MRI before radical prostatectomy are enrolled in this retrospective study. Eighty-four patients have organ confined disease and the remaining twenty-six patients have EPE all verified by histopathology. Prostate MRI examinations were conducted with 3T MRI scanner and phased array coil with the following sequences: T2 WI, T1 WI, DCE, DWI with ADC mapping, and high b-value at b = 1500 s/mm2. The likelihood of EPE with 5-point Likert scale was assigned, several MRI features were extracted for each dominant tumor identified by using T2 WI. Tumors with Likert scales 4–5 were evaluated further to obtain MRI-based RD. The relationship between pathological and MRI-determined RD was tested. Univariate and multivariate logistic regression models were developed to detect the grade of pathological EPE. The inputs were among the 2 clinical parameters and 4 MRI features.

Results

There is a moderate correlation between pathological RD and MRI-determined RD (ρ = 0.45, P < 0.01). In univariate and multivariate models, MRI features and clinical parameters possess varying significance levels (univariate models; P = 0.048–0.788, multivariate models; P = 0.173–0.769). Multivariate models perform better than the univariate models by offering fair to good performances (AUC = 0.69–0.85). The multivariate model that employs the MRI features offers better performance than the model employs clinical parameters (AUC = 0.81 versus 0.69).

Conclusion

Co-existence of T2 WI signs provide higher diagnostic value even than clinical parameters in predicting the grade of EPE. Combined use of clinical parameters and MRI features deliver slightly superior performance than MRI features alone.

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Acknowledgements

We thank Tugrul Bahtiyar Koroglu, radiology technician for assistance with reviewing all the radiology databases of our institution that gave great contribution to this manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Baskent University, Maresal Fevzi Cakmak Blvd, No: 45, Cankaya, Ankara, Turkey

    Aslihan Onay

  2. Department of Biomedical Engineering, Yeditepe University, 34755, Kayisdagi, Istanbul, Turkey

    Gokhan Ertas

  3. Department of Radiology, VKV American Hospital, 34365, Sisli, Istanbul, Turkey

    Metin Vural

  4. Department of Electrical and Electronics Engineering, Ankara University, Bahcelievler Mah, 06830, Golbasi, Ankara, Turkey

    Evrim Colak

  5. Department of Urology, School of Medicine, Koc University, Davutpasa Street No:4, Topkapi, 34010, Istanbul, Turkey

    Tarik Esen

  6. Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Fatih, 34093, Istanbul, Turkey

    Baris Bakir

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  1. Aslihan Onay
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  2. Gokhan Ertas
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Correspondence to Aslihan Onay.

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Onay, A., Ertas, G., Vural, M. et al. The role of T2-weighted images in assessing the grade of extraprostatic extension of the prostate carcinoma. Abdom Radiol 45, 3293–3300 (2020). https://doi.org/10.1007/s00261-020-02419-4

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