AI Article Synopsis
- This study evaluated how well multiparametric MRI (mpMRI), Ga-PSMA-11 PET/CT, and their combination can diagnose extracapsular extension (ECE) in prostate cancer patients.
- Researchers analyzed 75 prostate cancer patients' imaging results against their pathology findings, using ROC analysis and PI-RADS scoring to assess diagnostic performance.
- The combination of mpMRI and PET/CT significantly improved ECE detection and accurately predicted T staging in high-risk lesions, with 87% correct staging in patients with PI-RADS 4-5 lesions.
Article Abstract
Background: In this study, we explored the diagnostic performances of multiparametric magnetic resonance imaging (mpMRI), Ga-PSMA-11 PET/CT and combination of Ga-PSMA-11 PET/CT and mpMRI (mpMRI + PET/CT) for extracapsular extension (ECE). Based on the analyses above, we tested the feasibility of using mpMRI + PET/CT results to predict T staging in prostate cancer patients.
Methods: By enrolling 75 patients of prostate cancer with mpMRI and Ga-PSMA-11 PET/CT before radical prostatectomy, we analyzed the detection performances of ECE in mpMRI, Ga-PSMA-11 PET/CT and mpMRI + PET/CT on their lesion images matched with their pathological sample images layer by layer through receiver operating characteristics (ROC) analysis. By inputting the lesion data into Prostate Imaging Reporting and Data System (PI-RADS), we divided the lesions into different PI-RADS scores. The improvement of detecting ECE was analyzed by net reclassification improvement (NRI). The predictors for T staging were evaluated by using univariate and multivariable analysis. The Kappa test was used to evaluate the prediction ability.
Results: One hundred three regions of lesion were identified from 75 patients. 50 of 103 regions were positive for ECE. The ECE diagnosis AUC of mpMRI + PET/CT is higher than that of mpMRI alone (ΔAUC = 0.101; 95% CI, 0.0148 to 0.1860; p < 0.05, respectively). Compared to mpMRI, mpMRI + PET/CT has a significant improvement in detecting ECE in PI-RADS 4-5 (NRI 36.1%, p < 0.01). The diagnosis power of mpMRI + PET/CT was an independent predictor for T staging (p < 0.001) in logistic regression analysis. In patients with PI-RADS 4-5 lesions, 40 of 46 (87.0%) patients have correct T staging prediction from mpMRI + PET/CT (κ 0.70, p < 0.01).
Conclusion: The prediction of T staging in PI-RADS 4-5 prostate cancer patients by mpMRI + PET/CT had a quite good performance.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712094 | PMC |
| http://dx.doi.org/10.1186/s12894-023-01376-6 | DOI Listing |
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