Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2019
Thesis Language: Turkish
Student: Dr. Umut Asfuroğlu
Supervisor: MURAT UÇAR
Abstract:Multiparametric prostate MRI (mpMRI) is accepted as the most sensitive imaging modality in local staging of prostate cancer. Accurate evaluation of possible extraprostatic extension in preoperative period has an important role to decide surgical method, outcome and oncologic evaluation. The aim of this study is to evaluate the pre-operative MpMRI of patients with prostate cancer who underwent radical prostatectomy and to evaluate the radiological-pathological correlation in local staging. In this study, patients who underwent radical prostatectomy after biopsyproven prostate cancer with 3-T MpMRI between January 2016 and April 2019 were included retrospectively. The likelihood of extraprostatic extension was independently reviewed by two radiologists who blinded to histopathological results using Likert score, ESUR criteria and MRI parameters defined in PI-RADS v2. The interreader agreement was determined using a weighted kappa coefficient. Diagnostic performance indicators were evaluated by sensitivity, specificity, positive and negative predictive values and diagnostic accuracy in extraprostatic extension analysis. A p <0.05 was considered significant. Of the 79 patients included in our study, 46 (58%) didn’t have extraprostatic extension (EPE) and 33 (42%) had histopathologically EPE. For both observers, 65 PI-RADS v2 sensitivity and negative predictive values were higher than PI-RADS v1 in EPY detection. In PI-RADS v1, specificity and positive predictive values were found higher than PI-RADS v2 for both observers. The diagnostic accuracy of Likert score was higher than PI-RADS v1 for both observers. However, depending on experience and subjectivity, sensitivity and specificity values are variable. In the detection of EPE, the predictive value of tumor contact length (TCL) was 14.75 mm and 11.5 mm, respectively. PI-RADS v2 reduce understaging in locally advanced prostate cancer. PIRADS v2, patient selection for nerve-sparing surgery, active surveillance and focal therapy can be more successful