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 and Peter A Pinto

PLOS ONE, 2016, vol. 11, issue 6, 1-13

Abstract: 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.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0157313

DOI: 10.1371/journal.pone.0157313

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