Standardized threshold approach using three-dimensional proton magnetic resonance spectroscopic imaging in prostate cancer localization of the entire prostate.
Publication year
2007Source
Investigative Radiology, 42, 2, (2007), pp. 116-22ISSN
Publication type
Article / Letter to editor
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Organization
Radiology
Pathology
Urology
Journal title
Investigative Radiology
Volume
vol. 42
Issue
iss. 2
Page start
p. 116
Page end
p. 22
Subject
CTR 1: Functional imaging; IGMD 8: Mitochondrial medicine; NCEBP 1: Molecular epidemiology; NCMLS 4: Energy and redox metabolism; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 3: Translational research; ONCOL 5: Aetiology, screening and detection; UMCN 1.1: Functional ImagingAbstract
OBJECTIVES: We sought to determine the localization accuracy using 3-dimensional (3D) proton magnetic resonance spectroscopic imaging (MRSI) of the entire prostate with a standardized thresholds approach in prostate cancer patients. MATERIALS AND METHODS: In a prospective study, 32 consecutive patients were examined. Mean age and prostate specific antigen level were 61 years and 7.8 ng/mL, respectively. Median biopsy Gleason score was 6. T2-weighted MRI and 3D MRSI of the entire prostate were performed. Three readers recorded the location of suspicious peripheral zone and central gland cancer nodules on a standardized division of the prostate (14 regions of interest [ROI]) using a standardized thresholds approach. The degree of diagnostic confidence for each ROI was recorded on a 5-point scale. Reconstructed whole-mount section histopathology was the standard of reference. The sensitivity, specificity, positive, and negative predictive value, overall accuracy and interobserver agreement were calculated. Areas under the ROI-based receiver operating characteristic curve (AUC) and diagnostic performance parameters were determined. RESULTS: The standardized thresholds approach had an accuracy of 81% and an AUC of 0.85-0.86 for differentiation between benign and malignant ROIs in the peripheral zone and an accuracy of 87% and an AUC of 0.86-0.91 for this differentiation in the central gland, respectively. Specificities of 81% to 88% were achieved with accompanying sensitivities of 75% to 92% for both peripheral zone and central gland, respectively. Moderate to near-perfect interobserver agreement was demonstrated (kappa=0.42-0.91). CONCLUSION: Our data indicate that a standardized zone-specific threshold approach in MRSI of the prostate is able to prospectively differentiate between benign and malignant tissues in the peripheral zone and the central gland with good accuracy and interobserver agreement.
This item appears in the following Collection(s)
- Academic publications [246515]
- Electronic publications [134102]
- Faculty of Medical Sciences [93308]
- Open Access publications [107627]
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