Mahjoub, Samy ORCID: 0000-0001-5151-1853, Baur, Alexander D. J., Lenk, Julian, Lee, Chau Hung, Hartenstein, Alexander, Rudolph, Madhuri M., Cash, Hannes, Hamm, Bernd, Asbach, Patrick, Haas, Matthias and Penzkofer, Tobias (2020). Optimizing size thresholds for detection of clinically significant prostate cancer on MRI: Peripheral zone cancers are smaller and more predictable than transition zone tumors. Eur. J. Radiol., 129. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: To evaluate if size-based cut-offs based on MR imaging can successfully assess clinically significant prostate cancer (csPCA). The goal was to improve the currently applied size-based differentiation criterion in PIRADS. Methods and materials: MRIs of 293 patients who had undergone 3 T MR imaging with subsequent confirmation of prostate cancer on systematic and targeted MRI/TRUS-fusion biopsy were re-read by three radiologists. All identifiable tumors were measured on T2WI for lesions originating in the transition zone (TZ) and on DWI for lesions from the peripheral zone (PZ) and tabulated against their Gleason grade. Results: 309 lesions were analyzed, 213 (68.9 %) in the PZ and 96 (31.1 %) in the TZ. ROC-Analysis showed a stronger correlation between lesion size and clinically significant (defined as Gleason Grade Group= 2) prostate cancer (PCa) for the PZ (AUC= 0.73) compared to the TZ (AUC= 0.63). The calculated Youden index resulted in size cut-offs of 14mm for PZ and 21mm for TZ tumors. Conclusion: Size cut-offs can be used to stratify prostate cancer with different optimal size thresholds in the peripheral zone and transition zone. There was a clearer separation of clinically significant tumors in peripheral zone cancers compared to transition zone cancers. Future iterations of PI-RADS could therefore take different size-based cut-offs for peripheral zone and transition zone cancers into account.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Mahjoub, SamyUNSPECIFIEDorcid.org/0000-0001-5151-1853UNSPECIFIED
Baur, Alexander D. J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lenk, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lee, Chau HungUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartenstein, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, Madhuri M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cash, HannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamm, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Asbach, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haas, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Penzkofer, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-325329
DOI: 10.1016/j.ejrad.2020.109071
Journal or Publication Title: Eur. J. Radiol.
Volume: 129
Date: 2020
Publisher: ELSEVIER IRELAND LTD
Place of Publication: CLARE
ISSN: 1872-7727
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PI-RADS; CARCINOMA; COHORT; RISKMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32532

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