How good is multiparametric Magnetic Resonance Imaging in predicting prostatectomy histopathology?

Abstract

Objective:

To analyse the value of multiparametric Magnetic Resonance Imaging (MRI) in preoperative staging of prostate cancer.

Patients and Methods:

Patients who underwent Robotic‐assisted Laparoscopic Radical Prostatectomy (RaLRP) in our hospital between January 2007 and June 2018 preoperative MRI were captured using the Clinical Management System. Relationship between PI‐RADS score and upstaging and upgrading of prostate cancer was analysed using logistic regression.

Results:

300 patients were eligible for the study. The rate of upstaging in final histopathology compared to MRI clinical T staging is 45.3%. For T2 disease, the sensitivity, specificity, positive predictive value and negative predictive value are 79.6%, 26.7%, 82.7% and 28.1% respectively. For T3 disease, the sensitivity, specificity, positive predictive value and negative predictive value are 23.5%, 94.2%, 80.0% and 83.1% respectively. PI‐RADS score was reported in 59 patients. The PI‐RADS score was graded 3, 4 and 5 in 35.6%, 47.5% and 16.9% patients respectively. The proportion of Gleason score >= 7 in final histopathology in PI‐RADS score 3, 4 and 5 are 61.9%, 64.3% and 70.0% respectively.

Conclusion:

The paper illustrated that MRI is good in predicting T3 disease. PI‐RADS score does not seem to be closely related to Gleason score of the tumour.