MP42-15 INVASION OF PROSTATIC CAPSULE: CAN PREOPERATIVE MP-MRI PREDICT THE INFORMATIONS OF PATHOLOGICAL ANALYSIS (2014)

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2014MP42-15 INVASION OF PROSTATIC CAPSULE: CAN PREOPERATIVE MP-MRI PREDICT THE INFORMATIONS OF PATHOLOGICAL ANALYSIS Francesco Porpiglia, Filippo Russo, Matteo Manfredi, Fabrizio Mele, Riccardo Bertolo, Daniele Amparore, Diletta Garrou, Susanna Grande, Cristian Fiori, Enrico Bollito, Mauro Papotti, and Daniele Regge Francesco PorpigliaFrancesco Porpiglia More articles by this author , Filippo RussoFilippo Russo More articles by this author , Matteo ManfrediMatteo Manfredi More articles by this author , Fabrizio MeleFabrizio Mele More articles by this author , Riccardo BertoloRiccardo Bertolo More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Diletta GarrouDiletta Garrou More articles by this author , Susanna GrandeSusanna Grande More articles by this author , Cristian FioriCristian Fiori More articles by this author , Enrico BollitoEnrico Bollito More articles by this author , Mauro PapottiMauro Papotti More articles by this author , and Daniele ReggeDaniele Regge More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1192AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Multiparametric magnetic resonance imaging (mp-MRI) provides precise identification of focal areas and local staging of prostate cancer (PCa); particularly, is able to show extracapsular extension and seminal vesicle invasion which have significant implications for patient management. However, surgeons would like to have informations about prostatic capsular invasion (PCI) to choose the most appropriate surgical technique for each patient during radical prostatectomy (RP). In pathologic setting, Wheeler et al proposed a classification of levels of PCI that provides valuable prognostic information. Aim of our study was to evaluate the ability of mp-MRI in identifying PCI by comparing its results with those obtained with histopathological analysis. Methods The study included 230 consecutive patients with PCa who underwent preoperative MRI before RP. Mp-MRI: a conventional study with T1-w, T2-w and diffusion sequences was performed. After precontrast acquisitions, patients were intravenously given gadobutrol and a total of 28 phases were acquired, each lasting 13 seconds. All images were examined by an expert uro-radiologist. Surgery: Patients underwent robot-assisted RP by the same surgeon. Pathological analysis: After RP, all specimens were reviewed by the same uro-pathologist. Both for MRI and pathological analysis the location and extent of each cancer was identified, and detailed tumor maps were prepared for each case. The level of PCI for each lesion was defined as Level 0 (L0) Tumor confined to prostatic stroma within the boundary of normal prostatic acini; L1: Tumor confined to prostatic stroma, but outside the boundary of normal prostatic acini, L2: Tumor confined to the prostate but within a layer more fibrous than muscular (capsule); L3F Tumor outside the prostate to a depth of less than one high-power field on no more than two separate sections; L3E: Any amount of extraprostatic tumor more than L3, as reported by Wheeler. Results The pathological report revealed: 39 pT2a-b; 120 pT2c; 46 pT3a and 25 pT3b stage prostate cancer, overall number of tumor lesion was 421. Mp-MRI correctly identified 149/163 (91.4%), 88/95 (92.6%), 56/59 (94.9%) and 15/15 (100%) lesions classified by pathological analysis as L0-1, L2, L3F and L3E, respectively. Cohen's kappa coefficient was 0.911. Conclusions MRI was able to correctly identify a significant number of tumor lesions and the level of PCI was predicted with almost perfect agreement with pathological analysis. On the basis of these results we think that mp-MRI is basic piece in the mosaic of the RP’s tailoring. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e474 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Francesco Porpiglia More articles by this author Filippo Russo More articles by this author Matteo Manfredi More articles by this author Fabrizio Mele More articles by this author Riccardo Bertolo More articles by this author Daniele Amparore More articles by this author Diletta Garrou More articles by this author Susanna Grande More articles by this author Cristian Fiori More articles by this author Enrico Bollito More articles by this author Mauro Papotti More articles by this author Daniele Regge More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...