Clinical implications of prostatic capsular abutment or bulging on multiparametric magnetic resonance imaging.
In this study we aimed to test the clinical implications of capsular abutment or bulging on preoperative multiparametric magnetic resonance imaging (mpMRI). METHODS: We analyzed the data of 291 patients who underwent radical prostatectomy (RP) for a cT1-2N0 prostate cancer in a single surgeon series. All patients underwent preoperative staging with mpMRI. PIRADS v2 was used for characterizing lesions. The role of capsular abutment or bulging was tested in a multivariable logistic regression adjusting for PSA and highest ipsilateral biopsy Gleason grade. The presence of focal vs. extensive ECE was investigated. RESULTS: Overall, ECE on final pathology was documented in 35 (12%) cases and ECE was focal in 32 (91%) patients. Overall, mpMRI demonstrated capsule bulging or abutment in 12 (24%) cases. After adjusting for confounders, capsule bulging or abutment on mpMRI emerged as predictor for ECE (OR: 6.70; 95% CI: 2.97,15.12, p
CONCLUSIONS: First, our meta-analysis shows moderate sensitivity and high specificity for mpMRI to differentiate ECE from organ-confined prostate cancer before surgery. Second, our meta-analysis shows that mpMRI had no significant differences in performance compared with the former meta-analysis with use of T2-weighted imaging alone or with additional functional MRI. ADVANCES IN KNOWLEDGE: It is the first meta-analysis to evaluate the accuracy of multiparametric MRI in combination of T2-weighted imaging, DWI and DCE-MRI for extracapsular extension detection. PMID: 31596123 [PubMed - as supplied by publisher]
ConclusionsNot only mp-MRI and MRI-targeted sampling, but also concomitant systematic biopsies provide significant information to identify patients at a higher risk of adverse pathology. Although omitting systematic prostate sampling at the time of MRI-targeted biopsy might be associated with a reduced risk of detecting insignificant PCa and lower patient discomfort, it reduces the ability to accurately predict pathological features.Patient summaryThe combination of multiparametric magnetic resonance imaging (mp-MRI) with accurate biopsy information on MRI-targeted and systematic biopsies improves the accuracy of multivari...
ConclusionsOur data demonstrate a promising new strategy to predict PPI through the perfusion quality of pelvic muscle structures with contrast media kinetics. This may facilitate preoperative patient consulting and decision-making.
ConclusionSRT to the macroscopic recurrence identified by mpMRI is a feasible and well-tolerated option. In this study, there were no differences in bRFS between MRI-positive and MRI-negative patients, indicating effective targeting of MRI-positive lesions.
This article presents an overview of the current literature on PET imaging with prostate-specific membrane antigen ligands, especially focusing on the potential role of simultaneous PET/magnetic resonance imaging for the planning of salvage radiotherapy in patients with prostate cancer with biochemical recurrence after radical prostatectomy. PMID: 31472746 [PubMed - in process]
Conclusions: Whole-gland salvage BT is an effective treatment with an acceptable toxicity profile. The pathology findings from RARP imply that there is a room for improvement in diagnoses made by MRI in the pre-salvage setting. PMID: 31435426 [PubMed]
This article presents an overview of the current literature on PET imaging with prostate-specific membrane antigen ligands, especially focusing on the potential role of simultaneous PET/magnetic resonance imaging for the planning of salvage radiotherapy in patients with prostate cancer with biochemical recurrence after radical prostatectomy.
ConclusionIn this external cohort, the CADx and PI-RADSv2 scores showed similar performances in characterizing ISUP grade ≥ 2 cancers.
Objectives: To determine the prognostic significance of tissue stiffness measurement using transrectal ultrasound shear wave elastography in predicting biochemical recurrence following radical prostatectomy for clinically localized prostate cancer. Patients and Methods: eligible male patients with clinically localized prostate cancer and extraperitoneal laparoscopic radical prostatectomy between November 2013 and August 2017 were retrospectively selected. Information of potential biochemical recurrence predictors, including imaging (ultrasound shear wave elastography and Magnetic Resonance Imaging), clinicopathological c...
AbstractTo evaluate if diffusion tensor imaging (DTI) is able to detect morphological changes of peri-prostatic neurovascular fibers (PNF) before and after robot-assisted radical prostatectomy (RARP) and if these changes are related to urinary incontinence (UI) and erectile dysfunction (ED). From October 2014 and August 2017, 26 patients with biopsy-proven prostate cancer underwent prostatic multiparametric magnetic resonance imaging (mp-MRI) including DTI sequencing before, and 6 months after, RARP. Images were analyzed by placing six regions of interest (ROI), respectively, at base, mid gland, and apex, one for each side...