Five-Point Likert Scaling on MRI Predicts Clinically Significant Prostate Carcinoma

Taisuke Harada; Takashige Abe; Fumi Kato; Ryuji Matsumoto; Hiromi Fujita; Sachiyo Murai; Naoto Miyajima; Kunihiko Tsuchiya; Satoru Maruyama; Kohsuke Kudo; Nobuo Shinohara

Disclosures

BMC Urol. 2015;15(91) 

In This Article

Abstract

Background: To clarify the relationship between the probability of prostate cancer scaled using a 5-point Likert system and the biological characteristics of corresponding tumor foci.

Methods: The present study involved 44 patients undergoing 3.0-Tesla multiparametric MRI before laparoscopic radical prostatectomy. Tracing based on pathological and MRI findings was performed. The relationship between the probability of cancer scaled using the 5-point Likert system and the biological characteristics of corresponding tumor foci was evaluated.

Results: A total of 102 tumor foci were identified histologically from the 44 specimens. Of the 102 tumors, 55 were assigned a score based on MRI findings (score 1: n = 3; score 2: n = 3; score 3: n = 16; score 4: n = 11 score 5: n = 22), while 47 were not pointed out on MRI. The tracing study revealed that the proportion of >0.5 cm3 tumors increased according to the upgrade of Likert scores (score 1 or 2: 33 %; score 3: 68.8 %; score 4 or 5: 90.9 %, χ 2 test, p < 0.0001). The proportion with a Gleason score >7 also increased from scale 2 to scale 5 (scale 2: 0 %; scale 3: 56.3 %; scale 4: 72.7 %; 5: 90.9 %, χ 2 test, p = 0.0001). On using score 3 or higher as the threshold of cancer detection on MRI, the detection rate markedly improved if the tumor volume exceeded 0.5 cm3 (<0.2 cm3 : 10.3 %; 0.2–0.5 cm3 : 25 %; 0.5–1.0 cm3 : 66.7 %; 1.0 < cm3 : 92.1 %).

Conclusions: Each Likert scale favobably reflected the corresponding tumor's volume and Gleason score. Our observations show that "score 3 or higher" could be a useful threshold to predict clinically significant carcinoma when considering treatment options.

processing....