Extraprostatic extension in prostate cancer: primer for radiologists.
Extraprostatic extension
Multiparametric MRI
PI-RADS v2
Radical prostatectomy
Tumor capsule contact length
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
12
5
2020
medline:
22
6
2021
entrez:
12
5
2020
Statut:
ppublish
Résumé
The presence of extraprostatic extension (EPE) on multiparametric MRI (mpMRI) is an important factor in determining the management of prostate cancer. EPE is an established risk factor for biochemical recurrence of prostate cancer after radical prostatectomy (RP) and patients with EPE may be considered for wider resection margins, non-nerve-sparing surgery, adjuvant radiation therapy (RT), or androgen deprivation therapy (ADT). Several statistical nomograms and scoring systems have been developed to predict pathological stage at time of RP but with varying accuracies. Using the current PI-RADS v2 mpMRI staging guidelines results in high specificity but lacks in sensitivity. These findings reveal the need for more standardization and further refinement of existing MRI protocols and prostate cancer prediction tools. Current studies have looked into indirect additional imaging criteria such as index tumor volume, length of capsular contact, and apparent diffusion coefficient. Measuring for these features can improve the robustness of mpMRI in staging prostate cancer, as they have been shown to be independent predictors of EPE. MRI/ultrasound fusion-guided targeted biopsy can detect EPE not found on standard biopsy. Collectively, these measurements and imaging techniques can augment the detection of EPE and subsequent risk stratification.
Identifiants
pubmed: 32390076
doi: 10.1007/s00261-020-02555-x
pii: 10.1007/s00261-020-02555-x
doi:
Substances chimiques
Androgen Antagonists
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4040-4051Références
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