epartment of Radiology, Faculty of Medicine, TOBB ETÜ University, Ankara, Turkey
Department of Radiology, Medical Faculty, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
Turk J Med Sci. 2021 Aug 30;51(4):1940-1952. doi: 10.3906/sag-2012-55.
BACKROUND/AIM: In prostate cancer, extraprostatic extension (EPE) is an unfavorable prognostic factor, and the grade of EPE is correlated with the prognosis. This study aims to evaluate the utility of length of capsular contact (LCC ) in predicting the grade of EPE by correlating the measurements from MRI images and the measurements performed from radical prostatectomy specimens.
MR images and specimens of 110 tumors are analyzed retrospectively. The specimens are used as reference to validate the presence of EPE and to measure the ground truth LCC. MR images are evaluated by two radiologists to identify the presence of EPE and to predict the LCC indirectly. Reliability, accuracy, sensitivity, and specificity of the evaluations are analyzed in comparison with the findings obtained from the specimens.
In detection of EPE existence, the radiologists achieve almost the same performance (all AUCs = 0.73) with optimal cut-off values lead to moderate sensitivity and specificity pairs (For cut-off = 15.8 mm; Se = 0.69, Sp = 0.68 and for cut-off of 14.5 mm: Se = 0.77, Sp = 0.62). In distinguishing high-grade EPE from low-grade EPE, the radiologists accomplish very similar performances (AUCs = 0.73 and 0.72) Optimal thresholds of 20.0 mm and 18.5 mm for the readers retrospectively reveal medium sensitivity and specificity pairs (Se = 0.64, Sp = 0.67; Se = 0.64, Sp = 0.67).
Consistent LCC estimates can be obtained from MR images providing a beneficial metric for detecting the existence of EPE and for discriminating the grades of EPE.
背景/目的：在前列腺癌中，前列腺外延伸（EPE）是一个不利的预后因素，EPE 的程度与预后相关。本研究旨在通过将 MRI 图像测量值与根治性前列腺切除术标本的测量值相关联，评估包膜接触长度（LCC）预测 EPE 程度的效用。
回顾性分析了 110 个肿瘤的 MRI 图像和标本。标本被用作参考，以验证 EPE 的存在，并测量真实的 LCC。两名放射科医生评估 MRI 图像以识别 EPE 的存在，并间接预测 LCC。分析评估的可靠性、准确性、敏感性和特异性，并与标本获得的结果进行比较。
在检测 EPE 的存在方面，放射科医生的表现几乎相同（所有 AUC = 0.73），最佳截断值导致中等敏感性和特异性组合（对于截断值 = 15.8mm；Se = 0.69，Sp = 0.68，对于截断值为 14.5mm：Se = 0.77，Sp = 0.62）。在区分高级 EPE 与低级 EPE 方面，放射科医生的表现非常相似（AUC = 0.73 和 0.72），读者回顾性地选择的最佳阈值为 20.0mm 和 18.5mm，产生中等敏感性和特异性组合（Se = 0.64，Sp = 0.67；Se = 0.64，Sp = 0.67）。
可以从 MRI 图像中获得一致的 LCC 估计值，为检测 EPE 的存在和区分 EPE 的程度提供有益的指标。
