Value analysis of magnetic resonance imaging in diagnosing prostate cancer capsular invasion

Abstract

This study aimed to investigate the diagnostic utility of Magnetic Resonance Imaging (MRI) in detecting extracapsular extension (ECE) in prostate cancer (PCa). The data of 120 patients admitted to the hospital was retrieved and assessed. All patients underwent laparoscopic radical prostatectomy, and ECE status was determined by postoperative pathological examination. The results showed that 41 patients exhibited prostatic capsule invasion. Multiple logistic regression analysis identified Prostate-Specific Antigen (PSA) ≥10.4 ng/mL, biopsy Gleason score ≥7, clinical stage T2c, positive MRI findings, and Apparent Diffusion Coefficient (ADC) value < 0.75 × 10−3 mm2/s as significant risk factors for prostatic capsule invasion. The predictive model equation was Logit(P) = −1.325 + 0.469 × PSA ≥10.4 ng/mL + 0.865 × biopsy Gleason score ≥7 + 1.743 × positive MRI findings + 1.495 × ADC value < 0.75 × 10−3 mm2/s. The receiver operating characteristic (ROC) curve yielded an area under the curve (AUC) of 0.769 (95% Confidence Interval (CI): 0.681–0.856, p < 0.001). In conclusion, these results indicate that integrating MRI with clinical risk factors in the predictive model demonstrates robust performance in identifying prostatic capsule invasion, demonstrating promising ability to enhance diagnostic and therapeutic strategies for PCa management.

Keywords

• magnetic resonance imaging
• prostate cancer
• extra-capsular extension
• diagnosis