PLoS ONE (Jan 2016)

Preoperative Multiparametric Magnetic Resonance Imaging Predicts Biochemical Recurrence in Prostate Cancer after Radical Prostatectomy.

  • Richard Ho,
  • Mohummad M Siddiqui,
  • Arvin K George,
  • Thomas Frye,
  • Amichai Kilchevsky,
  • Michele Fascelli,
  • Nabeel A Shakir,
  • Raju Chelluri,
  • Steven F Abboud,
  • Annerleim Walton-Diaz,
  • Sandeep Sankineni,
  • Maria J Merino,
  • Baris Turkbey,
  • Peter L Choyke,
  • Bradford J Wood,
  • Peter A Pinto

DOI
https://doi.org/10.1371/journal.pone.0157313
Journal volume & issue
Vol. 11, no. 6
p. e0157313

Abstract

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OBJECTIVES:To evaluate the utility of preoperative multiparametric magnetic resonance imaging (MP-MRI) in predicting biochemical recurrence (BCR) following radical prostatectomy (RP). MATERIALS/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). CONCLUSION: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.