title: Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study.
abstract: OBJECTIVE
  To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.
  
  
  METHODS
  One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n = 71) or 3 T (n = 104), with (n = 58) or without (n = 117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.
  
  
  RESULTS
  Readers identified 192-214/362 cancers, with 130-155 false positives. Detection rates for tumours of <0.5 cc (cm(3)), 0.5-2 cc and >2 cc were 33-45/155 (21-29 %), 15-19/35 (43-54 %) and 8-9/12 (67-75 %) for Gleason ≤6, 17/27 (63 %), 42-45/51 (82-88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P < 0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P < 0.005) and aggressiveness of tumours (P < 0.00001).
  
  
  CONCLUSIONS
  Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.
  
  
  CONCLUSIONS
  • Prostate cancer volume, Gleason score, architecture and location are MRI predictors of detection. • Field strength and coils used do not influence the tumour detection rate. • Multiparametric MRI is accurate for detecting aggressive tumours. • A subjective suspicion score can stratify the risk of malignancy and tumour aggressiveness.
authors.affiliation: Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon 69437, France.
authors.forename: Flavie
authors.initials: F
authors.lastname: Bratan
authors.forename: Emilie
authors.initials: E
authors.lastname: Niaf
authors.forename: Christelle
authors.initials: C
authors.lastname: Melodelima
authors.forename: Anne Laure
authors.initials: AL
authors.lastname: Chesnais
authors.forename: Rémi
authors.initials: R
authors.lastname: Souchon
authors.forename: Florence
authors.initials: F
authors.lastname: Mège-Lechevallier
authors.forename: Marc
authors.initials: M
authors.lastname: Colombel
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouvière
mesh_terms: D000368:Aged; D001706:Biopsy; D003287:Contrast Media / Q000494:pharmacology*; D016208:Databases, Factual; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005189:False Positive Reactions; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D017430:Prostate-Specific Antigen