TY - JOUR
T1 - Diagnostic performance of prospectively assigned Likert scale scores to determine extraprostatic extension and seminal vesicle invasion with multiparametric MRI of the prostate
AU - Freifeld, Yuval
AU - DeLeon, Alberto Diaz
AU - Xi, Yin
AU - Pedrosa, Ivan
AU - Roehrborn, Claus G.
AU - Lotan, Yair
AU - Francis, Franto
AU - Costa, Daniel N.
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2019/3
Y1 - 2019/3
N2 - OBJECTIVE. The objective of this study was to determine the diagnostic performance of a prospectively assigned 5-point Likert scale for determination of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). MATERIALS AND METHODS. This study was a single-center, retrospective analysis of prospectively collected data including all men with abnormal 3-T multiparametric MRI and subsequent radical prostatectomy between November 1, 2016, and September 30, 2017. Scores from a 5-point subjective Likert scale (1 = highly unlikely, 5 = highly likely) for the likelihood of EPE and SVI were prospectively assigned during clinical MRI interpretation. EPE and SVI status at whole-mount prostatectomy specimen served as the standard of reference. RESULTS. Among the 89 eligible men, whole-mount histopathology revealed organ-confined prostate cancer, EPE, and SVI in 49% (44/89), 46% (41/89), and 18% (16/89) of patients, respectively. Of the pathologically proven cases of EPE, 18% (2/11), 17% (4/24), 65% (17/26), 46% (6/13) and 80% (12/15) were assigned Likert scores of 1–5, respectively. Of the pathologically proven cases of SVI, 5% (3/58), 11% (2/18), 66% (2/3), 66% (2/3) and 100% (7/7) were assigned Likert scores of 1–5, respectively. The positive predictive values for scores of 4 or 5 were 64% for EPE and 90% for SVI. The negative predictive values for scores of 1 or 2 were 87% for EPE and 93% for SVI. Likert scores for EPE (odds ratio, 2.1; 95% CI, 1.3–3.4) and for SVI (odds ratio, 4.7; 95% CI, 2.3–9.6) were both associated with EPE and SVI on multivariate analysis. CONCLUSION. A 5-point Likert scale can effectively convey the degree of suspicion of EPE and SVI on multiparametric MRI of the prostate, facilitating informed decision-making.
AB - OBJECTIVE. The objective of this study was to determine the diagnostic performance of a prospectively assigned 5-point Likert scale for determination of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). MATERIALS AND METHODS. This study was a single-center, retrospective analysis of prospectively collected data including all men with abnormal 3-T multiparametric MRI and subsequent radical prostatectomy between November 1, 2016, and September 30, 2017. Scores from a 5-point subjective Likert scale (1 = highly unlikely, 5 = highly likely) for the likelihood of EPE and SVI were prospectively assigned during clinical MRI interpretation. EPE and SVI status at whole-mount prostatectomy specimen served as the standard of reference. RESULTS. Among the 89 eligible men, whole-mount histopathology revealed organ-confined prostate cancer, EPE, and SVI in 49% (44/89), 46% (41/89), and 18% (16/89) of patients, respectively. Of the pathologically proven cases of EPE, 18% (2/11), 17% (4/24), 65% (17/26), 46% (6/13) and 80% (12/15) were assigned Likert scores of 1–5, respectively. Of the pathologically proven cases of SVI, 5% (3/58), 11% (2/18), 66% (2/3), 66% (2/3) and 100% (7/7) were assigned Likert scores of 1–5, respectively. The positive predictive values for scores of 4 or 5 were 64% for EPE and 90% for SVI. The negative predictive values for scores of 1 or 2 were 87% for EPE and 93% for SVI. Likert scores for EPE (odds ratio, 2.1; 95% CI, 1.3–3.4) and for SVI (odds ratio, 4.7; 95% CI, 2.3–9.6) were both associated with EPE and SVI on multivariate analysis. CONCLUSION. A 5-point Likert scale can effectively convey the degree of suspicion of EPE and SVI on multiparametric MRI of the prostate, facilitating informed decision-making.
KW - Imaging-pathology correlation
KW - Local staging
KW - MRI
KW - Prostate cancer
KW - Risk stratification
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U2 - 10.2214/AJR.18.20320
DO - 10.2214/AJR.18.20320
M3 - Article
C2 - 30589381
AN - SCOPUS:85061981558
SN - 0361-803X
VL - 212
SP - 576
EP - 581
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -