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Mass-like peripheral zone enhancement on CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer.
Glazer, D I; Davenport, M S; Khalatbari, S; Cohan, R H; Ellis, J H; Caoili, E M; Stein, E B; Childress, J C; Masch, W R; Brown, J M; Mollard, B J; Montgomery, J S; Palapattu, G S; Francis, I R.
Afiliação
  • Glazer DI; Department of Radiology, University of Michigan Health System, B2-A209P, Ann Arbor, MI, 48109, USA.
Abdom Imaging ; 40(3): 560-70, 2015 Mar.
Article em En | MEDLINE | ID: mdl-25193787
PURPOSE: To determine whether focal peripheral zone enhancement on routine venous-phase CT is predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer. MATERIALS AND METHODS: IRB approval was obtained and informed consent waived for this HIPAA-compliant retrospective study. Forty-three patients with higher-grade prostate cancer (≥Gleason 4 + 3) and 96 with histology-confirmed lower-grade (≤Gleason 3 + 4 [n = 47]) or absent (n = 49) prostate cancer imaged with venous-phase CT comprised the study population. CT images were reviewed by ten blinded radiologists (5 attendings, 5 residents) who scored peripheral zone enhancement on a scale of 1 (benign) to 5 (malignant). Mass-like peripheral zone enhancement was considered malignant. Likelihood ratios (LR) and specificities were calculated. Multivariate conditional logistic regression analyses were conducted. RESULTS: Scores of "5" were strongly predictive of higher-grade prostate cancer (pooled LR+ 9.6 [95% CI 5.8-15.8]) with rare false positives (pooled specificity: 0.98 [942/960, 95% CI 0.98-0.99]; all 10 readers had specificity ≥95%). Attending scores of "5" were more predictive than resident scores of "5" (LR+: 14.7 [95% CI 5.8-37.2] vs. 7.6 [95% CI 4.2-13.7]) with similar specificity (0.99 [475/480, 95% CI 0.98-1.00] vs. 0.97 [467/480, 95% CI 0.96-0.99]). Significant predictors of an assigned score of "5" included presence of a peripheral zone mass (p < 0.0001), larger size (p < 0.0001), and less reader experience (p = 0.0008). Significant predictors of higher-grade prostate cancer included presence of a peripheral zone mass (p = 0.0002) and larger size (p < 0.0001). CONCLUSION: Focal mass-like peripheral zone enhancement on routine venous-phase CT is specific and predictive of higher-grade (Gleason 4 + 3 and higher) prostate cancer.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Intensificação de Imagem Radiográfica / Tomografia Computadorizada por Raios X Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Intensificação de Imagem Radiográfica / Tomografia Computadorizada por Raios X Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article