A comparative analysis of techniques for measuring tumor contact length in predicting extraprostatic extension

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Extraprostatic extension (EPE) is a critical factor in prostate cancer staging and treatment planning.
• Accurate detection of EPE using magnetic resonance imaging (MRI) is essential for guiding surgical and therapeutic decisions.

Purpose of the Study:

• To evaluate the diagnostic performance of curvilinear and linear measurement methods in different MRI sequences for detecting EPE in prostate cancer.
• To assess the added value of apparent diffusion coefficient (ADC) in detecting EPE.

Main Methods:

• Retrospective analysis of 84 patients who underwent multiparametric MRI (mp-MRI) before radical prostatectomy.
• Assessment of tumor contact length (TCL) using curvilinear and linear methods on T2WI, ADC maps, and DCE-MRI.
• Statistical analysis including ROC curve analysis to determine diagnostic performance and logistic regression for prediction models.

Main Results:

• Dynamic contrast-enhanced MRI (DCE-MRI) sequences showed higher AUC values for EPE prediction compared to other sequences.
• Curvilinear and linear TCL measurements demonstrated comparable diagnostic performance, with linear TCL being more practical.
• Multivariable models incorporating mean ADC values significantly improved EPE prediction performance (AUC up to 0.919).

Conclusions:

• DCE-MRI is superior for predicting EPE in prostate cancer.
• Linear TCL measurement is a practical and effective method for EPE detection.
• Apparent diffusion coefficient (ADC) values provide significant additional diagnostic value for EPE detection.