title: Prediction of Micrometastasis (< 1 cm) to Pelvic Lymph Nodes in Prostate Cancer: Role of Preoperative MRI.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively investigate whether preoperative MRI plays a key role in clinical prediction of micrometastasis (< 1 cm) to pelvic lymph nodes in prostate cancer.
  
  
  METHODS
  One hundred one patients with prostate cancer who underwent preoperative MRI and radical prostatectomy with pelvic lymph node dissection were included. None of the patients had a pelvic lymph node with a short-axis diameter of 1 cm or larger on MRI. Both clinical (prostate-specific antigen, biopsy Gleason score, greatest percentage of biopsy core, and percentage of positive cores) and MRI parameters (tumor apparent diffusion coefficient and tumor staging) were assessed. The univariate, multivariate, and ROC curve analyses were conducted.
  
  
  RESULTS
  Of 101 patients, nine (8.9%) had pelvic lymph node metastases. In univariate analysis, all of the clinical and MRI parameters were related to micrometastasis to pelvic lymph nodes (p < 0.05). However, multivariate analysis revealed that only preoperative MRI stage was significant (p = 0.044). AUC of preoperative MRI stage was 0.954 (odds ratio, 21.7). Respective sensitivity and specificity of preoperative tumor staging by MRI were 100% and 65.2% with cutoff of T3a or more, and 88.9% and 94.6% with cutoff of T3b for predicting micrometastasis to pelvic lymph nodes.
  
  
  CONCLUSIONS
  Preoperative MRI staging may play a role in prediction of micrometastasis (< 1 cm) to pelvic lymph nodes in prostate cancer.
authors: 1 Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors: Sung Yoon
authors: SY
authors: Park
authors: 1 Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors: Young Taik
authors: YT
authors: Oh
authors: 1 Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors: Dae Chul
authors: DC
authors: Jung
authors: 2 Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Nam Hoon
authors: NH
authors: Cho
authors: 3 Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Young Deuk
authors: YD
authors: Choi
authors: 3 Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Koon Ho
authors: KH
authors: Rha
mesh_terms: D000368:Aged; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D061206:Neoplasm Micrometastasis / Q000473:pathology*; D009367:Neoplasm Staging; D010388:Pelvis; D011237:Predictive Value of Tests; D011300:Preoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: MRI; lymph node metastasis; micrometastasis; prostate cancer; tumor staging