Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume
To retrospectively determine the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using s...
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| Veröffentlicht in: | Radiology 2009-08, Vol.252 (2), p.449-457 |
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| creator | MAZAHERI, Yousef HRICAK, Hedvig TOUIJER, KarimA KOUTCHER, Jason A FINE, Samson W AKIN, Oguz SHUKLA-DAVE, Amita ISHILL, Nicole M MOSKOWITZ, Chaya S GRATER, Joanna E REUTER, Victor E ZAKIAN, Kristen L |
| description | To retrospectively determine the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard.
The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm(3) at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated.
In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm(2)/sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm(3) were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm(2)/sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm(2)/sec) was significantly higher (P = .006) than that of T2-weighted imaging alone.
Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement.
http://radiology.rsnajnls.org/cgi/content/full/252/2/449/DC1. |
| doi_str_mv | 10.1148/radiol.2523081423 |
| format | Article |
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The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm(3) at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated.
In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm(2)/sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm(3) were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm(2)/sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm(2)/sec) was significantly higher (P = .006) than that of T2-weighted imaging alone.
Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement.
http://radiology.rsnajnls.org/cgi/content/full/252/2/449/DC1.</description><identifier>ISSN: 0033-8419</identifier><identifier>EISSN: 1527-1315</identifier><identifier>DOI: 10.1148/radiol.2523081423</identifier><identifier>PMID: 19703883</identifier><identifier>CODEN: RADLAX</identifier><language>eng</language><publisher>Oak Brook, IL: Radiological Society of North America</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Diffusion Magnetic Resonance Imaging - methods ; Gynecology. Andrology. Obstetrics ; Humans ; Image Interpretation, Computer-Assisted - methods ; Imaging, Three-Dimensional - methods ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Male genital diseases ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; Organ Size ; Prostatic Neoplasms - pathology ; Reproducibility of Results ; Sensitivity and Specificity ; Statistics as Topic ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>Radiology, 2009-08, Vol.252 (2), p.449-457</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f272d4fab40bc9bfe1ea633aec65e1f1a4f1e39acdda494e1c2da564402d3563</citedby><cites>FETCH-LOGICAL-c372t-f272d4fab40bc9bfe1ea633aec65e1f1a4f1e39acdda494e1c2da564402d3563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21766208$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19703883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MAZAHERI, Yousef</creatorcontrib><creatorcontrib>HRICAK, Hedvig</creatorcontrib><creatorcontrib>TOUIJER, KarimA</creatorcontrib><creatorcontrib>KOUTCHER, Jason A</creatorcontrib><creatorcontrib>FINE, Samson W</creatorcontrib><creatorcontrib>AKIN, Oguz</creatorcontrib><creatorcontrib>SHUKLA-DAVE, Amita</creatorcontrib><creatorcontrib>ISHILL, Nicole M</creatorcontrib><creatorcontrib>MOSKOWITZ, Chaya S</creatorcontrib><creatorcontrib>GRATER, Joanna E</creatorcontrib><creatorcontrib>REUTER, Victor E</creatorcontrib><creatorcontrib>ZAKIAN, Kristen L</creatorcontrib><title>Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume</title><title>Radiology</title><addtitle>Radiology</addtitle><description>To retrospectively determine the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard.
The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm(3) at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated.
In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm(2)/sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm(3) were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm(2)/sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm(2)/sec) was significantly higher (P = .006) than that of T2-weighted imaging alone.
Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement.
http://radiology.rsnajnls.org/cgi/content/full/252/2/449/DC1.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Diffusion Magnetic Resonance Imaging - methods</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Organ Size</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Statistics as Topic</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>0033-8419</issn><issn>1527-1315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1r3DAQhkVJabZpf0AuwZf05lQjybKdW9h-BRIaytKrGUujXQXbSiSZ0F_Qv12XXbr0NAPzvO_Aw9g58CsA1XyMaH0YrkQlJG9ACfmKraASdQkSqhO24lzKslHQnrK3KT1yDqpq6jfsFNqay6aRK_b7IYaUMVOxmccQi59hmEcq7gnTHGmkKRcvPu-KdRh7P5EtNqJ8Ib_d5WW_HXHrp22Bky0-eefm5MN0PN__uF5yMdKAeTnsix4w78IQtt789_Ede-1wSPT-MM_Y5svnzfpbeff96-365q40sha5dKIWVjnsFe9N2zsCQi0lktEVgQNUDki2aKxF1SoCIyxWWikurKy0PGMf9rVPMTzPlHI3-mRoGHCiMKdO15pXUtcLCHvQLH5SJNc9RT9i_NUB7_7K7_byu6P8JXNxKJ_7kewxcbC9AJcHAJPBwUWcjE__OAG11oI38g8SpJFN</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>MAZAHERI, Yousef</creator><creator>HRICAK, Hedvig</creator><creator>TOUIJER, KarimA</creator><creator>KOUTCHER, Jason A</creator><creator>FINE, Samson W</creator><creator>AKIN, Oguz</creator><creator>SHUKLA-DAVE, Amita</creator><creator>ISHILL, Nicole M</creator><creator>MOSKOWITZ, Chaya S</creator><creator>GRATER, Joanna E</creator><creator>REUTER, Victor E</creator><creator>ZAKIAN, Kristen L</creator><general>Radiological Society of North America</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume</title><author>MAZAHERI, Yousef ; HRICAK, Hedvig ; TOUIJER, KarimA ; KOUTCHER, Jason A ; FINE, Samson W ; AKIN, Oguz ; SHUKLA-DAVE, Amita ; ISHILL, Nicole M ; MOSKOWITZ, Chaya S ; GRATER, Joanna E ; REUTER, Victor E ; ZAKIAN, Kristen L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f272d4fab40bc9bfe1ea633aec65e1f1a4f1e39acdda494e1c2da564402d3563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Diffusion Magnetic Resonance Imaging - methods</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Organ Size</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Statistics as Topic</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MAZAHERI, Yousef</creatorcontrib><creatorcontrib>HRICAK, Hedvig</creatorcontrib><creatorcontrib>TOUIJER, KarimA</creatorcontrib><creatorcontrib>KOUTCHER, Jason A</creatorcontrib><creatorcontrib>FINE, Samson W</creatorcontrib><creatorcontrib>AKIN, Oguz</creatorcontrib><creatorcontrib>SHUKLA-DAVE, Amita</creatorcontrib><creatorcontrib>ISHILL, Nicole M</creatorcontrib><creatorcontrib>MOSKOWITZ, Chaya S</creatorcontrib><creatorcontrib>GRATER, Joanna E</creatorcontrib><creatorcontrib>REUTER, Victor E</creatorcontrib><creatorcontrib>ZAKIAN, Kristen L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MAZAHERI, Yousef</au><au>HRICAK, Hedvig</au><au>TOUIJER, KarimA</au><au>KOUTCHER, Jason A</au><au>FINE, Samson W</au><au>AKIN, Oguz</au><au>SHUKLA-DAVE, Amita</au><au>ISHILL, Nicole M</au><au>MOSKOWITZ, Chaya S</au><au>GRATER, Joanna E</au><au>REUTER, Victor E</au><au>ZAKIAN, Kristen L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume</atitle><jtitle>Radiology</jtitle><addtitle>Radiology</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>252</volume><issue>2</issue><spage>449</spage><epage>457</epage><pages>449-457</pages><issn>0033-8419</issn><eissn>1527-1315</eissn><coden>RADLAX</coden><abstract>To retrospectively determine the accuracy of diffusion-weighted (DW) magnetic resonance (MR) imaging for identifying cancer in the prostate peripheral zone (PZ) and to assess the accuracy of tumor volume measurements made with T2-weighted imaging and combined T2-weighted and DW MR imaging by using surgical pathologic examination as the reference standard.
The institutional review board issued a waiver of informed consent for this HIPAA-compliant study. Forty-two patients underwent endorectal MR at 1.5 T before undergoing radical prostatectomy for prostate cancer and had at least one PZ tumor larger than 0.1 cm(3) at surgical pathologic examination. On T2-weighted images, an experienced radiologist outlined suspected PZ tumors. Two apparent diffusion coefficient (ADC) cutoff values were identified by using the Youden index and published literature. Image cluster analysis was performed on voxels within the suspected tumor regions. Associations between volume measurements from imaging and from pathologic examination were assessed by using concordance correlation coefficients (CCCs). The sensitivity and specificity of ADCs for identifying malignant PZ voxels were calculated.
In identifying malignant voxels, respective ADC cutoff values of 0.0014 and 0.0016 mm(2)/sec yielded sensitivity of 82% and 95% and specificity of 85% and 65%, respectively. Sixty PZ cancer lesions larger than 0.1 cm(3) were found at pathologic examination; 43 were detected by the radiologist. CCCs between imaging and pathologic tumor volume measurements were 0.36 for T2-weighted imaging, and 0.46 and 0.60 for combined T2-weighted and DW MR imaging with ADC cutoffs of 0.0014 and 0.0016 mm(2)/sec, respectively; the CCC of combined T2-weighted and DW MR imaging (ADC cutoff, 0.0016 mm(2)/sec) was significantly higher (P = .006) than that of T2-weighted imaging alone.
Adding DW MR to T2-weighted imaging can significantly improve the accuracy of prostate PZ tumor volume measurement.
http://radiology.rsnajnls.org/cgi/content/full/252/2/449/DC1.</abstract><cop>Oak Brook, IL</cop><pub>Radiological Society of North America</pub><pmid>19703883</pmid><doi>10.1148/radiol.2523081423</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Diffusion Magnetic Resonance Imaging - methods Gynecology. Andrology. Obstetrics Humans Image Interpretation, Computer-Assisted - methods Imaging, Three-Dimensional - methods Investigative techniques, diagnostic techniques (general aspects) Male Male genital diseases Medical sciences Middle Aged Nephrology. Urinary tract diseases Organ Size Prostatic Neoplasms - pathology Reproducibility of Results Sensitivity and Specificity Statistics as Topic Tumors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Prostate Tumor Volume Measurement with Combined T2-weighted Imaging and Diffusion-weighted MR: Correlation with Pathologic Tumor Volume |
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