Department of Radiology, Tata Medical Center, 14 MAR (E-W), Rajarhat, Newtown, West Bengal, Kolkata, 700160, India.
Department of Urological Oncology, Tata Medical Center, 14 MAR (E-W), Rajarhat, Newtown, Kolkata, West Bengal, 700160, India.
Abdom Radiol (NY). 2021 Oct;46(10):4984-4994. doi: 10.1007/s00261-021-03194-6. Epub 2021 Jun 29.
To evaluate the performance of non-erectile MRI in staging and preoperative evaluation of penile carcinomas, compared to postoperative histopathology.
In this retrospective study, MRI scans of patients who had undergone surgery for penile carcinoma (n = 54) between January 2012 and April 2018 were read by two radiologists; and disagreement was solved in the presence of a third experienced radiologist. Data necessary for preoperative evaluation and staging were collected and compared with final postoperative histology and the type of surgery performed. All MRI had been performed without intracavernosal injection of prostaglandin E1 and with IV Gadolinium, as per local protocol.
54 patients were included in the study (mean age 57.52 ± 12.78). The number of patients with T1, T2, and T3 staging in histopathology were 32, 14, and 8. Moderate interobserver agreement was found for staging, disease-free penile length, and all subsites except urethra, which had weak agreement. Strong agreement of consensus MRI with final histopathological staging was found (49/54, weighted κ = 0.85), with high sensitivity and specificity. Sensitivity and specificity for involvement of corpus spongiosum, corpora cavernosa, and urethra were 95.5% and 93.8%, 87.5% and 97.8%, and 90.9% and 86.1%, respectively. Sensitivity (89.6%) and specificity (100%) of MRI for predicting adequate disease-free penile length were high.
There were acceptable interobserver agreement and good diagnostic performance of MRI for staging and preoperative assessment without intracavernosal injection, especially for higher stages and higher degrees of invasion which require more extensive surgery.
与术后组织病理学相比，评估非勃起 MRI 对阴茎癌分期和术前评估的性能。
在这项回顾性研究中，由两名放射科医生对 2012 年 1 月至 2018 年 4 月间因阴茎癌接受手术治疗的患者（n=54）的 MRI 扫描进行阅读；当存在第三位经验丰富的放射科医生时，解决了意见分歧。收集了术前评估和分期所需的数据，并与最终的术后组织病理学和所进行的手术类型进行了比较。所有 MRI 均按照当地方案进行，不进行前列腺素 E1 海绵体内注射，静脉内注射钆造影剂。
本研究共纳入 54 例患者（平均年龄 57.52±12.78 岁）。组织病理学上 T1、T2 和 T3 分期的患者分别为 32、14 和 8 例。分期、阴茎无瘤长度和除尿道以外的所有部位的疾病，观察者间的一致性中等，尿道的观察者间一致性较弱。共识 MRI 与最终的组织病理学分期具有很强的一致性（49/54，加权κ=0.85），具有较高的敏感性和特异性。海绵体和阴茎海绵体及尿道受累的敏感性和特异性分别为 95.5%和 93.8%、87.5%和 97.8%、90.9%和 86.1%。MRI 预测无瘤阴茎长度充足的敏感性（89.6%）和特异性（100%）均较高。
在不进行海绵体内注射的情况下，MRI 分期和术前评估的观察者间一致性可接受，诊断性能良好，尤其适用于需要更广泛手术的较高分期和较高侵袭程度的病变。
