title: Value of preoperative 3T multiparametric MRI for surgical margin status in patients with prostate cancer.
abstract: To examine the value of preoperative multiparametric magnetic resonance imaging (MRI) as a predictor of surgical margin (SM) status in patients with prostate cancer (PC).
  
  
  
  The Institutional Review Board approved this retrospective study; the requirement for informed consent was waived. Fifty-six male patients with histologically proven PC underwent preoperative 3T multiparametric MRI including high b value (0, 2000 s/mm(2) ) diffusion-weighted imaging. In each patient, clinical data, such as biopsy Gleason score and D'Amico clinical risk score, and multiparametric MRI findings, such as tumor location, tumor size, tumor extension in the apical or proximal region, tumor apparent diffusion coefficient (ADC), and the presence or absence of MRI findings of extracapsular extension (ECE) were evaluated. Statistical evaluations included the Fisher's exact test, χ(2) test, Mann-Whitney U-test, and logistic regression analysis.
  
  
  
  On histopathological evaluation, 15 patients (27%) were SM-positive (SMP group), and 41 (73%) were SM-negative (SMN group). The tumor ADC was significantly lower in the SMP group than in the SMN group (P = 0.001). The frequency of tumor extension in the apex or base and suspected ECE on MRI were significantly higher in the SMP group than in the SMN group (P = 0.037 and 0.011, respectively). On multivariate analysis, tumor ADC was the only predictor of SM status in PC (P = 0.003).
  
  
  
  PC with positive SM was characterized by tumor extension in the apical and proximal regions, lower tumor ADC, and tumors with positive MRI findings of ECE, compared to tumors with negative SM. J. Magn. Reson. Imaging 2016;44:584-593.
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tamada
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Sone
authors.affiliation: Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanomata
authors.affiliation: Department of Urology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miyaji
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Kido
authors.affiliation: Department of Urology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Jo
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Ito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D011300:Preoperative Care / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: diffusion magnetic resonance imaging; extracapsular extension; magnetic resonance imaging; prostatic neoplasms; surgical margin status; tumor localization