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Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer?

Publication ,  Journal Article
Gupta, RT; Brown, AF; Silverman, RK; Tay, KJ; Madden, JF; George, DJ; Polascik, TJ
Published in: AJR Am J Roentgenol
July 2016

OBJECTIVE: The purpose of this study is to investigate the accuracy of multiparametric MRI with endorectal coil and Partin tables in predicting organ-confined (OC) prostate cancer in a contemporary cohort undergoing radical prostatectomy (RP) and to assess the possible added value of radiologic staging based on multiparametric MRI to the predictive accuracy of Partin tables. MATERIALS AND METHODS: One hundred fifty-eight consecutive subjects underwent 3-T multiparametric MRI with endorectal coil before RP between November 2010 and November 2013. Data were randomly split 60% and 40% into derivation (n = 95) and validation (n = 62) datasets. Multiparametric MRI was used to assess the radiologic stage, and logistic regression models were created using the derivation dataset and were fit on the independent validation dataset using multiparametric MRI staging alone and with prostate-specific antigen (PSA) level as the covariate. The probability of each patient to harbor OC disease was calculated using an updated version of Partin tables, using either clinical staging from digital rectal examination (DRE) or radiologic staging (multiparametric MRI). The AUC was calculated to evaluate accuracy of these predictive methods. RESULTS: The accuracy of multiparametric MRI to predict OC disease on pathologic analysis was greater (AUC, 0.88) than that of Partin tables (AUC, 0.70) and improved when multiparametric MRI was combined with PSA level (AUC, 0.91). The accuracy of Partin nomograms to predict OC disease decreased (AUC, 0.63) when staging was based on multiparametric MRI versus DRE. CONCLUSION: The superior predictive accuracy of multiparametric MRI compared with Partin tables to predict OC disease validates the results of smaller previously published studies. Although there is no added benefit of substituting multiparametric MRI stage for clinical stage when using Partin tables, multiparametric MRI staging information is valuable as a stand-alone test.

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

July 2016

Volume

207

Issue

1

Start / End Page

87 / 95

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Nomograms
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

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Gupta, R. T., Brown, A. F., Silverman, R. K., Tay, K. J., Madden, J. F., George, D. J., & Polascik, T. J. (2016). Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer? AJR Am J Roentgenol, 207(1), 87–95. https://doi.org/10.2214/AJR.15.15878
Gupta, Rajan T., Alison Flanagan Brown, Rachel Kloss Silverman, Kae Jack Tay, John F. Madden, Daniel J. George, and Thomas J. Polascik. “Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer?AJR Am J Roentgenol 207, no. 1 (July 2016): 87–95. https://doi.org/10.2214/AJR.15.15878.
Gupta RT, Brown AF, Silverman RK, Tay KJ, Madden JF, George DJ, et al. Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer? AJR Am J Roentgenol. 2016 Jul;207(1):87–95.
Gupta, Rajan T., et al. “Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer?AJR Am J Roentgenol, vol. 207, no. 1, July 2016, pp. 87–95. Pubmed, doi:10.2214/AJR.15.15878.
Gupta RT, Brown AF, Silverman RK, Tay KJ, Madden JF, George DJ, Polascik TJ. Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer? AJR Am J Roentgenol. 2016 Jul;207(1):87–95.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

July 2016

Volume

207

Issue

1

Start / End Page

87 / 95

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Nomograms
  • Neoplasm Staging
  • Middle Aged
  • Male