DOI QR코드

DOI QR Code

Nomogram Models for Distinguishing Intraductal Carcinoma of the Prostate From Prostatic Acinar Adenocarcinoma Based on Multiparametric Magnetic Resonance Imaging

  • Ling Yang (Department of Radiology, West China Hospital, Sichuan University) ;
  • Xue-Ming Li (Department of Radiology, West China Hospital, Sichuan University) ;
  • Meng-Ni Zhang (Department of Pathology, West China Hospital, Sichuan University) ;
  • Jin Yao (Department of Radiology, West China Hospital, Sichuan University) ;
  • Bin Song (Department of Radiology, West China Hospital, Sichuan University)
  • Received : 2022.10.07
  • Accepted : 2023.05.16
  • Published : 2023.07.01

Abstract

Objective: To compare multiparametric magnetic resonance imaging (MRI) features of intraductal carcinoma of the prostate (IDC-P) with those of prostatic acinar adenocarcinoma (PAC) and develop prediction models to distinguish IDC-P from PAC and IDC-P with a high proportion (IDC ≥ 10%, hpIDC-P) from IDC-P with a low proportion (IDC < 10%, lpIDC-P) and PAC. Materials and Methods: One hundred and six patients with hpIDC-P, 105 with lpIDC-P and 168 with PAC, who underwent pretreatment multiparametric MRI between January 2015 and December 2020 were included in this study. Imaging parameters, including invasiveness and metastasis, were evaluated and compared between the PAC and IDC-P groups as well as between the hpIDC-P and lpIDC-P subgroups. Nomograms for distinguishing IDC-P from PAC, and hpIDC-P from lpIDC-P and PAC, were made using multivariable logistic regression analysis. The discrimination performance of the models was assessed using the receiver operating characteristic area under the curve (ROC-AUC) in the sample, where the models were derived from without an independent validation sample. Results: The tumor diameter was larger and invasive and metastatic features were more common in the IDC-P than in the PAC group (P < 0.001). The distribution of extraprostatic extension (EPE) and pelvic lymphadenopathy was even greater, and the apparent diffusion coefficient (ADC) ratio was lower in the hpIDC-P than in the lpIDC-P group (P < 0.05). The ROC-AUCs of the stepwise models based solely on imaging features for distinguishing IDC-P from PAC and hpIDC-P from lpIDC-P and PAC were 0.797 (95% confidence interval, 0.750-0.843) and 0.777 (0.727-0.827), respectively. Conclusion: IDC-P was more likely to be larger, more invasive, and more metastatic, with obviously restricted diffusion. EPE, pelvic lymphadenopathy, and a lower ADC ratio were more likely to occur in hpIDC-P, and were also the most useful variables in both nomograms for predicting IDC-P and hpIDC-P.

Keywords

References

  1. Zong Y, Montironi R, Massari F, Jiang Z, Lopez-Beltran A, Wheeler TM, et al. Intraductal carcinoma of the prostate: pathogenesis and molecular perspectives. Eur Urol Focus 2021;7:955-963 https://doi.org/10.1016/j.euf.2020.10.007
  2. van Leenders GJLH, van der Kwast TH, Grignon DJ, Evans AJ, Kristiansen G, Kweldam CF, et al. The 2019 International Society of Urological Pathology (ISUP) consensus conference on grading of prostatic carcinoma. Am J Surg Pathol 2020;44:e87-e99 https://doi.org/10.1097/PAS.0000000000001497
  3. Zhu S, Zhao JG, Chen JR, Liu ZH, Sun GX, Wang ZP, et al. Intraductal carcinoma of the prostate in prostate biopsy samples: correlation with aggressive pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer. Asian J Androl 2020;22:519-525 https://doi.org/10.4103/aja.aja_117_19
  4. Dinerman BF, Bernstein AN, Khani F, Hu JC. Intraductal carcinoma of the prostate: a risk for rapid recurrence. Urology 2017;105:e1-e2 https://doi.org/10.1016/j.urology.2017.03.030
  5. Wang Z, Zhu S, Zhao J, Nie L, Chen X, Zhang M, et al. The heterogeneity of intraductal carcinoma of the prostate is associated with different efficacy of standard first-line therapy for patients with metastatic castration-resistant prostate cancer. Prostate 2021;81:1191-1201 https://doi.org/10.1002/pros.24215
  6. Cai Q, Costa DN, Metter CK, Goldberg K, Roehrborn CG, Cadeddu J, et al. Sensitivity of multiparametric MRI and targeted biopsy for detection of adverse pathologies (cribriform gleason pattern 4 and intraductal carcinoma): correlation of detected and missed prostate cancer foci with whole mount histopathology. Urol Oncol 2022;40:452.e1-452.e8 https://doi.org/10.1016/j.urolonc.2022.07.012
  7. Mikoshi A, Miyai K, Hamabe F, Edo H, Ito K, Matsukuma S, et al. MRI-detectability and histological factors of prostate cancer including intraductal carcinoma and cribriform pattern. Prostate 2022;82:452-463 https://doi.org/10.1002/pros.24291
  8. Tonttila PP, Ahtikoski A, Kuisma M, Paakko E, Hirvikoski P, Vaarala MH. Multiparametric MRI prior to radical prostatectomy identifies intraductal and cribriform growth patterns in prostate cancer. BJU Int 2019;124:992-998 https://doi.org/10.1111/bju.14812
  9. Prendeville S, Gertner M, Maganti M, Pintilie M, Perlis N, Toi A, et al. Role of magnetic resonance imaging targeted biopsy in detection of prostate cancer harboring adverse pathological features of intraductal carcinoma and invasive cribriform carcinoma. J Urol 2018;200:104-113 https://doi.org/10.1016/j.juro.2018.01.081
  10. Currin S, Flood TA, Krishna S, Ansari A, McInnes MDF, Schieda N. Intraductal carcinoma of the prostate (IDC-P) lowers apparent diffusion coefficient (ADC) values among intermediate risk prostate cancers. J Magn Reson Imaging 2019;50:279-287 https://doi.org/10.1002/jmri.26594
  11. Briganti A, Larcher A, Abdollah F, Capitanio U, Gallina A, Suardi N, et al. Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores. Eur Urol 2012;61:480-487 https://doi.org/10.1016/j.eururo.2011.10.044
  12. Di Trapani E, Luzzago S, Peveri G, Catellani M, Ferro M, Cordima G, et al. A novel nomogram predicting lymph node invasion among patients with prostate cancer: the importance of extracapsular extension at multiparametric magnetic resonance imaging. Urol Oncol 2021;39:431.e15-431.e22 https://doi.org/10.1016/j.urolonc.2020.11.040
  13. Zhao J, Liu J, Sun G, Zhang M, Chen J, Shen P, et al. The prognostic value of the proportion and architectural patterns of intraductal carcinoma of the prostate in patients with de novo metastatic prostate cancer. J Urol 2019;201:759-768 https://doi.org/10.1016/j.juro.2018.10.016
  14. Guo CC, Epstein JI. Intraductal carcinoma of the prostate on needle biopsy: histologic features and clinical significance. Mod Pathol 2006;19:1528-1535 https://doi.org/10.1038/modpathol.3800702
  15. Mehralivand S, Shih JH, Harmon S, Smith C, Bloom J, Czarniecki M, et al. A grading system for the assessment of risk of extraprostatic extension of prostate cancer at multiparametric MRI. Radiology 2019;290:709-719 https://doi.org/10.1148/radiol.2018181278
  16. Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, et al. Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2. Eur Urol 2019;76:340-351 https://doi.org/10.1016/j.eururo.2019.02.033
  17. Thoeny HC, Froehlich JM, Triantafyllou M, Huesler J, Bains LJ, Vermathen P, et al. Metastases in normal-sized pelvic lymph nodes: detection with diffusion-weighted MR imaging. Radiology 2014;273:125-135 https://doi.org/10.1148/radiol.14132921
  18. Kato M, Hirakawa A, Kobayashi Y, Yamamoto A, Ishida R, Kamihira O, et al. Response of intraductal carcinoma of the prostate to androgen deprivation therapy predicts prostate cancer prognosis in radical prostatectomy patients. Prostate 2020;80:284-290 https://doi.org/10.1002/pros.23942
  19. McNeal JE, Yemoto CE. Spread of adenocarcinoma within prostatic ducts and acini. Morphologic and clinical correlations. Am J Surg Pathol 1996;20:802-814 https://doi.org/10.1097/00000478-199607000-00003
  20. Haroon UM, O'Grady-Coyne S, Davis NF, Gullmann C, Forde JC, Smyth GP, et al. Intraductal carcinoma of the prostate in an Irish prostate cancer patient cohort-an aggressive pathology and a strong familial link. Prostate Int 2020;8:107-111 https://doi.org/10.1016/j.prnil.2020.02.001
  21. Parry MA, Srivastava S, Ali A, Cannistraci A, Antonello J, Barros-Silva JD, et al. Genomic evaluation of multiparametric magnetic resonance imaging-visible and -nonvisible lesions in clinically localised prostate cancer. Eur Urol Oncol 2019;2:1-11. https://doi.org/10.1016/j.euo.2018.08.005
  22. Bill-Axelson A, Holmberg L, Garmo H, Taari K, Busch C, Nordling S, et al. Radical prostatectomy or watchful waiting in prostate cancer - 29-year follow-up. N Engl J Med 2018;379:2319-2329 https://doi.org/10.1056/NEJMoa1807801
  23. Shieh AC, Guler E, Ojili V, Paspulati RM, Elliott R, Ramaiya NH, et al. Extraprostatic extension in prostate cancer: primer for radiologists. Abdom Radiol (NY) 2020;45:4040-4051 https://doi.org/10.1007/s00261-020-02555-x
  24. Fedorov A, Vangel MG, Tempany CM, Fennessy FM. Multiparametric magnetic resonance imaging of the prostate: repeatability of volume and apparent diffusion coefficient quantification. Invest Radiol 2017;52:538-546 https://doi.org/10.1097/RLI.0000000000000382
  25. Hambrock T, Somford DM, Huisman HJ, van Oort IM, Witjes JA, Hulsbergen-van de Kaa CA, et al. Relationship between apparent diffusion coefficients at 3.0-T MR imaging and gleason grade in peripheral zone prostate cancer. Radiology 2011;259:453-461 https://doi.org/10.1148/radiol.11091409
  26. Waseda Y, Yoshida S, Takahara T, Kwee TC, Matsuoka Y, Saito K, et al. Utility of computed diffusion-weighted MRI for predicting aggressiveness of prostate cancer. J Magn Reson Imaging 2017;46:490-496 https://doi.org/10.1002/jmri.25593
  27. Wu X, Reinikainen P, Vanhanen A, Kapanen M, Vierikko T, Ryymin P, et al. Correlation between apparent diffusion coefficient value on diffusion-weighted MR imaging and Gleason score in prostate cancer. Diagn Interv Imaging 2017;98:63-71 https://doi.org/10.1016/j.diii.2016.08.009
  28. Rosenkrantz AB, Khalef V, Xu W, Babb JS, Taneja SS, Doshi AM. Does normalisation improve the diagnostic performance of apparent diffusion coefficient values for prostate cancer assessment? A blinded independent-observer evaluation. Clin Radiol 2015;70:1032-1037 https://doi.org/10.1016/j.crad.2015.05.011
  29. Litjens GJ, Hambrock T, Hulsbergen-van de Kaa C, Barentsz JO, Huisman HJ. Interpatient variation in normal peripheral zone apparent diffusion coefficient: effect on the prediction of prostate cancer aggressiveness. Radiology 2012;265:260-266 https://doi.org/10.1148/radiol.12112374
  30. Ranasinghe WKB, Troncoso P, Surasi DS, Ibarra Rovira JJ, Bhosale P, Szklaruk J, et al. Defining diagnostic criteria for prostatic ductal adenocarcinoma at multiparametric MRI. Radiology 2022;303:110-118 https://doi.org/10.1148/radiol.204732
  31. Vora Z, Manchanda S, Sharma R, Das CJ, Hari S, Mathur S, et al. Normalized apparent diffusion coefficient: a novel paradigm for characterization of endometrial and subendometrial lesions. Br J Radiol 2021;94:20201069
  32. Kryvenko ON, Gupta NS, Virani N, Schultz D, Gomez J, Amin A, et al. Gleason score 7 adenocarcinoma of the prostate with lymph node metastases: analysis of 184 radical prostatectomy specimens. Arch Pathol Lab Med 2013;137:610-617 https://doi.org/10.5858/arpa.2012-0128-OA
  33. Lindberg J, Kristiansen A, Wiklund P, Gronberg H, Egevad L. Tracking the origin of metastatic prostate cancer. Eur Urol 2015;67:819-822 https://doi.org/10.1016/j.eururo.2014.09.006
  34. Trinh VQ, Sirois J, Benzerdjeb N, Mansoori BK, Grosset AA, Albadine R, et al. The impact of intraductal carcinoma of the prostate on the site and timing of recurrence and cancer-specific survival. Prostate 2018;78:697-706 https://doi.org/10.1002/pros.23513
  35. Porter LH, Lawrence MG, Ilic D, Clouston D, Bolton DM, Frydenberg M, et al. Systematic review links the prevalence of intraductal carcinoma of the prostate to prostate cancer risk categories. Eur Urol 2017;72:492-495 https://doi.org/10.1016/j.eururo.2017.03.013
  36. Kato M, Tsuzuki T, Kimura K, Hirakawa A, Kinoshita F, Sassa N, et al. The presence of intraductal carcinoma of the prostate in needle biopsy is a significant prognostic factor for prostate cancer patients with distant metastasis at initial presentation. Mod Pathol 2016;29:166-173 https://doi.org/10.1038/modpathol.2015.146
  37. Zhao T, Liao B, Yao J, Liu J, Huang R, Shen P, et al. Is there any prognostic impact of intraductal carcinoma of prostate in initial diagnosed aggressively metastatic prostate cancer? Prostate 2015;75:225-232 https://doi.org/10.1002/pros.22906