Transition zone prostate cancers

Features, detection, localization, and staging at endorectal MR imaging

Oguz Akin, Evis Sala, Chaya S. Moskowitz, Kentaro Kuroiwa, Nicole M. Ishill, Darko Pucar, Peter T. Scardino, Hedvig Hricak

Research output: Contribution to journalReview article

300 Citations (Scopus)

Abstract

Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard and to assess MR imaging features of these cancers. Matherials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and κ statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used. Results: For identification of patients with transition zone cancers sensitivity and specificity were 75% and 87% respectively, for reader 1 and 80% and 78%, respectively for reader 2. Intel-reader agreement was fair. For detection of location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56% and 94%, respectively, for reader 1 and 28% and 93%, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer. Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.

Original languageEnglish (US)
Pages (from-to)784-792
Number of pages9
JournalRadiology
Volume239
Issue number3
DOIs
StatePublished - Jun 1 2006

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Prostatic Neoplasms
Magnetic Resonance Imaging
Neoplasms
Patient Transfer
ROC Curve
Health Insurance Portability and Accountability Act
Sensitivity and Specificity
Research Ethics Committees
Prostatectomy
Tumor Burden
Informed Consent
Magnetic Resonance Spectroscopy
Retrospective Studies
Logistic Models
Regression Analysis
Databases
Control Groups

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Akin, O., Sala, E., Moskowitz, C. S., Kuroiwa, K., Ishill, N. M., Pucar, D., ... Hricak, H. (2006). Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging. Radiology, 239(3), 784-792. https://doi.org/10.1148/radiol.2392050949

Transition zone prostate cancers : Features, detection, localization, and staging at endorectal MR imaging. / Akin, Oguz; Sala, Evis; Moskowitz, Chaya S.; Kuroiwa, Kentaro; Ishill, Nicole M.; Pucar, Darko; Scardino, Peter T.; Hricak, Hedvig.

In: Radiology, Vol. 239, No. 3, 01.06.2006, p. 784-792.

Research output: Contribution to journalReview article

Akin, O, Sala, E, Moskowitz, CS, Kuroiwa, K, Ishill, NM, Pucar, D, Scardino, PT & Hricak, H 2006, 'Transition zone prostate cancers: Features, detection, localization, and staging at endorectal MR imaging', Radiology, vol. 239, no. 3, pp. 784-792. https://doi.org/10.1148/radiol.2392050949
Akin, Oguz ; Sala, Evis ; Moskowitz, Chaya S. ; Kuroiwa, Kentaro ; Ishill, Nicole M. ; Pucar, Darko ; Scardino, Peter T. ; Hricak, Hedvig. / Transition zone prostate cancers : Features, detection, localization, and staging at endorectal MR imaging. In: Radiology. 2006 ; Vol. 239, No. 3. pp. 784-792.
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abstract = "Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard and to assess MR imaging features of these cancers. Matherials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and κ statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used. Results: For identification of patients with transition zone cancers sensitivity and specificity were 75{\%} and 87{\%} respectively, for reader 1 and 80{\%} and 78{\%}, respectively for reader 2. Intel-reader agreement was fair. For detection of location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56{\%} and 94{\%}, respectively, for reader 1 and 28{\%} and 93{\%}, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer. Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.",
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T2 - Features, detection, localization, and staging at endorectal MR imaging

AU - Akin, Oguz

AU - Sala, Evis

AU - Moskowitz, Chaya S.

AU - Kuroiwa, Kentaro

AU - Ishill, Nicole M.

AU - Pucar, Darko

AU - Scardino, Peter T.

AU - Hricak, Hedvig

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Y1 - 2006/6/1

N2 - Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard and to assess MR imaging features of these cancers. Matherials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and κ statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used. Results: For identification of patients with transition zone cancers sensitivity and specificity were 75% and 87% respectively, for reader 1 and 80% and 78%, respectively for reader 2. Intel-reader agreement was fair. For detection of location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56% and 94%, respectively, for reader 1 and 28% and 93%, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer. Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.

AB - Purpose: To retrospectively evaluate the accuracy of endorectal magnetic resonance (MR) imaging in the detection and local staging of transition zone prostate cancers, with pathologic analysis serving as the reference standard and to assess MR imaging features of these cancers. Matherials and Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived the informed consent requirement. An institutional database of 986 patients who underwent MR imaging before radical prostatectomy yielded 148 consecutive patients with at least one transition zone cancer at step-section pathologic analysis. An additional 46 patients without transition zone cancer were randomly selected as a control group. Two readers independently reviewed MR studies to identify patients with transition zone cancers and determine the location and local extent of these cancers. Imaging features that helped in the identification of transition zone cancers were recorded. Descriptive and κ statistics, as well as receiver operating characteristic and multivariate logistic regression analyses, were used. Results: For identification of patients with transition zone cancers sensitivity and specificity were 75% and 87% respectively, for reader 1 and 80% and 78%, respectively for reader 2. Intel-reader agreement was fair. For detection of location of transition zone cancer, the area under the receiver operating characteristic curve was 0.75 for reader 1 and 0.73 for reader 2. Interreader agreement was fair. The readers' accuracy in detecting transition zone cancer foci increased significantly (P = .001) as tumor volume increased. In the detection of extraprostatic extension of transition zone cancers, sensitivity and specificity were 56% and 94%, respectively, for reader 1 and 28% and 93%, respectively, for reader 2. Homogeneous low T2 signal intensity (P = .001 for reader 1, P < .001 for reader 2) and lenticular shape (P = .017 for reader 1) were significantly associated with the presence of transition zone cancer. Conclusion: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.

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