title: Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy.
abstract: OBJECTIVE
  To evaluate the utility of preoperative multiparametric magnetic resonance imaging (MP-MRI) in predicting biochemical recurrence (BCR) following radical prostatectomy (RP).
  
  
  METHODS
  From March 2007 to January 2015, 421 consecutive patients with prostate cancer (PCa) underwent preoperative MP-MRI and RP. BCR-free survival rates were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to identify clinical and imaging variables predictive of BCR. Logistic regression was performed to generate a nomogram to predict three-year BCR probability.
  
  
  RESULTS
  Of the total cohort, 370 patients met inclusion criteria with 39 (10.5%) patients experiencing BCR. On multivariate analysis, preoperative prostate-specific antigen (PSA) (p = 0.01), biopsy Gleason score (p = 0.0008), MP-MRI suspicion score (p = 0.03), and extracapsular extension on MP-MRI (p = 0.03) were significantly associated with time to BCR. A nomogram integrating these factors to predict BCR at three years after RP demonstrated a c-index of 0.84, outperforming the predictive value of Gleason score and PSA alone (c-index 0.74, p = 0.02).
  
  
  CONCLUSIONS
  The addition of MP-MRI to standard clinical factors significantly improves prediction of BCR in a post-prostatectomy PCa cohort. This could serve as a valuable tool to support clinical decision-making in patients with moderate and high-risk cancers.
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Richard
authors.identifier: http://orcid.org/0000-0002-6792-3411
authors.initials: R
authors.lastname: Ho
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.|Department of Surgery, Division of Urology, University of Maryland, Baltimore, Maryland, United States of America.
authors.forename: Mohummad M
authors.initials: MM
authors.lastname: Siddiqui
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Arvin K
authors.initials: AK
authors.lastname: George
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Thomas
authors.initials: T
authors.lastname: Frye
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Amichai
authors.initials: A
authors.lastname: Kilchevsky
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Michele
authors.initials: M
authors.lastname: Fascelli
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Nabeel A
authors.initials: NA
authors.lastname: Shakir
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Raju
authors.initials: R
authors.lastname: Chelluri
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Abboud
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Annerleim
authors.initials: A
authors.lastname: Walton-Diaz
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sankineni
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.affiliation: Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
mesh_terms: D000368:Aged; D001706:Biopsy; D000066491:Clinical Decision-Making; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D012008:Recurrence
chemical_list: D017430:Prostate-Specific Antigen