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Tytuł pozycji:

Preliminary Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Detect Residual Prostate Cancer Following Focal Therapy with Irreversible Electroporation.

Tytuł :
Preliminary Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging to Detect Residual Prostate Cancer Following Focal Therapy with Irreversible Electroporation.
Autorzy :
Scheltema MJ; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia; Academic Medical Center, Department of Urology, University of Amsterdam, The Netherlands. Electronic address: .
Chang JI; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia.
van den Bos W; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia.
Böhm M; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.
Delprado W; University of Notre Dame, Sydney, NSW, Australia.
Gielchinsky I; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia.
de Reijke TM; Academic Medical Center, Department of Urology, University of Amsterdam, The Netherlands.
de la Rosette JJ; Academic Medical Center, Department of Urology, University of Amsterdam, The Netherlands.
Siriwardana AR; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia.
Shnier R; Southern Radiology, Randwick, Sydney, NSW, Australia.
Stricker PD; St. Vincent's Prostate Cancer Centre, Department of Urology, Darlinghurst, Sydney, NSW, Australia.
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Źródło :
European urology focus [Eur Urol Focus] 2019 Jul; Vol. 5 (4), pp. 585-591.
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: Amsterdam : Elsevier B.V., [2015]-
MeSH Terms :
Electrochemotherapy*/methods
Multiparametric Magnetic Resonance Imaging*
Prostatic Neoplasms/*diagnostic imaging
Prostatic Neoplasms/*drug therapy
Aged ; Humans ; Male ; Middle Aged ; Neoplasm, Residual ; Prostatic Neoplasms/pathology ; Reproducibility of Results ; Retrospective Studies
Contributed Indexing :
Keywords: Focal therapy*; IRE*; Irreversible electroporation*; MRI*; Multiparametric MRI*; Prostate*; Prostate cancer*
Entry Date(s) :
Date Created: 20171106 Date Completed: 20201022 Latest Revision: 20201022
Update Code :
20201218
DOI :
10.1016/j.euf.2017.10.007
PMID :
29102671
Czasopismo naukowe
Background: It is recommended to perform multiparametric magnetic resonance imaging (mpMRI) in the follow-up following focal therapy of prostate cancer (PCa).
Objective: To determine the diagnostic accuracy of mpMRI to detect residual PCa following focal therapy with irreversible electroporation.
Design, Setting, and Participants: Seventy-six patients with biopsy-proven localized PCa consented for primary irreversible electroporation between February 2013 and March 2016. Final analysis was performed on 50 patients that received follow-up mpMRI at 6 mo, serial prostate-specific antigen (PSA) testing, and transperineal template-mapping biopsies at 12 mo.
Outcome Measurements and Statistical Analysis: Outfield regions of interest (ROI) were reported using PI-RADS version 2. A binary outcome (suspicious vs nonsuspicious) was given for the infield ablation zone. Sensitivity, specificity, positive predictive values, and negative predictive values were calculated for different definitions of significant PCa: (1) Gleason ≥4+3 or Gleason ≥3+3 with a maximum cancer core length ≥6mm, (2) Gleason ≥3+4 or Gleason ≥3+3 with a maximum cancer core length ≥4mm, for outfield and infield ROI. Multivariate linear regression analyses evaluated the additional value of nadir PSA.
Results and Limitations: Sensitivity, specificity, positive predictive values, and negative predictive values of infield ROI was 43%, 86%, 33%, and 90% for definition 1 and 38%, 86%, 33%, and 88% for definition 2, respectively. For outfield ROI this was 33%, 82%, 20%, and 90% for definition 1 and 38%, 86%, 50%, and 80% for definition 2. PSA had no additional value in predicting residual significant PCa. Limitations include retrospective design, single reader, and low incidence of residual PCa.
Conclusions: Our preliminary data suggest that mpMRI can rule out high-volume residual PCa. However, follow-up biopsies should still be performed to determine oncological control.
Patient Summary: Multiparametric magnetic resonance imaging is able to detect high-volume significant prostate cancer following focal therapy. Prostate biopsies are still required in the follow-up of focal therapy as (low-volume) significant prostate cancer is being missed by multiparametric magnetic resonance imaging.
(Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

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