کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3867035 1598936 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of Multiparametric Endorectal Coil Prostate Magnetic Resonance Imaging on Disease Reclassification Among Active Surveillance Candidates: A Prospective Cohort Study
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Impact of Multiparametric Endorectal Coil Prostate Magnetic Resonance Imaging on Disease Reclassification Among Active Surveillance Candidates: A Prospective Cohort Study
چکیده انگلیسی

PurposeWe report magnetic resonance imaging findings among unselected men with low risk prostate cancer before active surveillance.Materials and MethodsWe prospectively enrolled men with low grade, low risk, localized prostate cancer. All patients underwent multiparametric endorectal coil magnetic resonance imaging and were offered confirmatory biopsy within 1 year of imaging. The primary outcome was the impact of magnetic resonance imaging on identifying patients who were reclassified by confirmatory biopsy as no longer fulfilling active surveillance criteria. We further identified clinical parameters associated with reclassification. The cohort was stratified as patients with 1) normal magnetic resonance imaging, 2) cancer on magnetic resonance imaging concordant with initial biopsy (less than 1 cm) and 3) cancer on magnetic resonance imaging larger than 1 cm. We performed univariate analysis to assess differences in clinical parameters among the groups.ResultsMagnetic resonance imaging did not detect cancer in 23 cases (38%) while magnetic resonance imaging and initial biopsy were concordant in 24 (40%). Magnetic resonance imaging detected a 1 cm or larger lesion in 13 patients (22%). Of the cases 18 (32.14%) were reclassified. When no cancer was identified on magnetic resonance imaging, only 2 cases (3.5%) were reclassified. The positive and negative predictive values for magnetic resonance imaging predicting reclassification were 83% (95% CI 73–93) and 81% (95% CI 71–91), respectively. Prostate specific antigen density was increased in patients with lesions larger than 1 cm on magnetic resonance imaging compared to those with no cancer on imaging (median 0.15 vs 0.07 ng/ml/cc, p = 0.016).ConclusionsMagnetic resonance imaging appears to have a high yield for predicting reclassification among men who elect active surveillance. Upon confirmation of our results magnetic resonance imaging may be used to better select and guide patients before active surveillance.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 187, Issue 4, April 2012, Pages 1247–1252
نویسندگان
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