Value of three-dimensional visualization of preoperative prostatic magnetic resonance imaging based on measurements of anatomical structures in predicting positive surgical margin after radical prostatectomy

Frontiers in Endocrinology

Endocrinology

Hao Wang¹  Yutong Wang¹  Zihan Xin¹  Xu Duan¹  Jiawen Luo²  Heming Pan³  Yuchao Wang⁴  Liang Wang⁴  Zhihong Dai⁴  Luxin Zhang⁴  Bo Fan⁴  Zhiyu Liu⁴  Jiaxin Xie⁵ 

[1] Department of Clinical Medicine, First Clinical School of Dalian Medical University, Dalian, Liaoning, China;Department of Radiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China;Department of Scientific Research, Dalian Neusoft University of Information, Dalian, Liaoning, China;Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China;Liaoning Provincial Key Laboratory of Urological Digital Precision Diagnosis and Treatment, the Liaoning Provincial Department of Science and Technology, Dalian, Liaoning, China;Liaoning Engineering Research Center of Integrated Precision Diagnosis and Treatment Technology for Urological Cancer, Liaoning Provincial Development and Reform Commission, Dalian, Liaoning, China;Dalian Key Laboratory of Prostate Cancer Research, Dalian Science and Technology Bureau, Dalian, Liaoning, China;Institute of Urology, Peking University, Beijing, China;

关键词: prostate cancer;    radical prostatectomy;    positive surgical margin;    magnetic resonance imaging;    three-dimensional visualization;   

DOI  :  10.3389/fendo.2023.1228892

 received in 2023-05-25, accepted in 2023-09-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPositive surgical margin (PSM) or apical positive surgical margin (APSM) is an established predictive factor of biochemical recurrence or disease progression in prostate cancer (PCa) patients after radical prostatectomy. Since there are limited usable magnetic resonance imaging (MRI)-based models, we sought to explore the role of three-dimensional (3D) visualization for preoperative MRI in the prediction of PSM or APSM.MethodsFrom December 2016 to April 2022, 149 consecutive PCa patients who underwent radical prostatectomy were retrospectively selected from the Second Affiliated Hospital of Dalian Medical University. According to the presence of PSM or APSM, patients were divided into a PSM group (n=41) and a without PSM group (n=108) and into an APSM group (n=33) and a without APSM group (n=116). Twenty-one parameters, including prostate apical shape, PCa distance to the membranous urethra, and pubic angle, were measured on 3D visualization of MRI. The development of the nomogram models was built by the findings of multivariate logistic regression analysis for significant factors.ResultsTo predict the probability of PSM, a longer PCa distance to the membranous urethra (OR=0.136, p=0.019) and the distance from the anterior peritoneum to the anterior border of the coccyx (work space AP, OR=0.240, p=0.030) were independent protective factors, while a type 3 prostate apical shape (OR=8.262, p=0.025) and larger pubic angle 2 (OR=5.303, p=0.029) were identified as independent risk factors. The nomogram model presented an area under the curve (AUC) of the receiver operating characteristic curve (ROC) of PSM of 0.777. In evaluating the incidence of APSM, we found that the distance to the membranous urethra (OR=0.135, p=0.014) was associated with a low risk of APSM, while larger pubic angle 1 (OR=4.666, p=0.043) was connected to a higher risk of APSM. The nomogram model showed that the AUC of APSM was 0.755.ConclusionAs 3D visualization for preoperative MRI showed good performance in predicting PSM or APSM, the tool might be potentially valuable, which also needs to be validated by multicenter, large-scale, prospective studies.

【 授权许可】

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Copyright © 2023 Fan, Zhang, Wang, Dai, Pan, Xie, Wang, Xin, Wang, Duan, Luo, Wang and Liu