caa a22 4500 605494126 CHVBK 20210128100524.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00261-014-0233-7 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0233-7 Mass-like peripheral zone enhancement on CT is predictive of higher-grade (Gleason 4+3 and higher) prostate cancer [Elektronische Daten] [D. Glazer, M. Davenport, S. Khalatbari, R. Cohan, J. Ellis, E. Caoili, E. Stein, J. Childress, W. Masch, J. Brown, B. Mollard, J. Montgomery, G. Palapattu, I. Francis] Purpose: To determine whether focal peripheral zone enhancement on routine venous-phase CT is predictive of higher-grade (Gleason 4+3 and higher) prostate cancer. Materials and methods: IRB approval was obtained and informed consent waived for this HIPAA-compliant retrospective study. Forty-three patients with higher-grade prostate cancer (≥Gleason 4+3) and 96 with histology-confirmed lower-grade (≤Gleason 3+4 [n=47]) or absent (n=49) prostate cancer imaged with venous-phase CT comprised the study population. CT images were reviewed by ten blinded radiologists (5 attendings, 5 residents) who scored peripheral zone enhancement on a scale of 1 (benign) to 5 (malignant). Mass-like peripheral zone enhancement was considered malignant. Likelihood ratios (LR) and specificities were calculated. Multivariate conditional logistic regression analyses were conducted. Results: Scores of "5” were strongly predictive of higher-grade prostate cancer (pooled LR+ 9.6 [95% CI 5.8-15.8]) with rare false positives (pooled specificity: 0.98 [942/960, 95% CI 0.98-0.99]; all 10 readers had specificity ≥95%). Attending scores of "5” were more predictive than resident scores of "5” (LR+: 14.7 [95% CI 5.8-37.2] vs. 7.6 [95% CI 4.2-13.7]) with similar specificity (0.99 [475/480, 95% CI 0.98-1.00] vs. 0.97 [467/480, 95% CI 0.96-0.99]). Significant predictors of an assigned score of "5” included presence of a peripheral zone mass (p<0.0001), larger size (p<0.0001), and less reader experience (p=0.0008). Significant predictors of higher-grade prostate cancer included presence of a peripheral zone mass (p=0.0002) and larger size (p<0.0001). Conclusion: Focal mass-like peripheral zone enhancement on routine venous-phase CT is specific and predictive of higher-grade (Gleason 4+3 and higher) prostate cancer. Springer Science+Business Media New York, 2014 Prostate cancer nationallicence CT nationallicence Peripheral zone nationallicence Repeatability nationallicence Likelihood ratio nationallicence Glazer D. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Davenport M. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Khalatbari S. Michigan Institute for Clinical and Health Research, Ann Arbor, MI, USA aut Cohan R. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Ellis J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Caoili E. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Stein E. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Childress J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Masch W. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Brown J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Mollard B. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Montgomery J. Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA aut Palapattu G. Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA aut Francis I. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 560-570 0942-8925 40:3<560 2015 40 261 https://doi.org/10.1007/s00261-014-0233-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0233-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Glazer D. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Davenport M. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Khalatbari S. Michigan Institute for Clinical and Health Research, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Cohan R. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Ellis J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Caoili E. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Stein E. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Childress J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Masch W. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Brown J. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Mollard B. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Montgomery J. Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Palapattu G. Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA aut NATIONALLICENCE 700 1- Francis I. Department of Radiology, University of Michigan Health System, B2-A209P, 48109, Ann Arbor, MI, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 560-570 0942-8925 40:3<560 2015 40 261