Evaluating Seminal Vesicle Invasion with Multiparametric Magnetic Resonance Imaging in Patients Diagnosed with Prostate Cancer: Is Radiologist Experience Effective?

Abstract

Bakcground: Predicting seminal vesicle invasion (SVI) in patients diagnosed with prostate cancer with multiparametric magnetic (mp) resonance imaging (MRI) provides more accurate local staging and thus more appropriate treatment management. Because mpMRI has a steep learning curve, radiologist experience is crucial. Our study aimed to show the difference that the experience of the uroradiologist would create in the detection rate of mpMRI and SVI by comparing it with radical prostatectomy tissue histopathology.

Materials and Methods: Patients with positive SVI in radical prostatectomy specimen were included in the study. The group of radiologists less experienced in genitourinary radiology was defined as Observer I, and experienced uroradiologists as Observer II (5 years and more than 2000 MR experience) and Observer III (4 years and more than 1000 MR experience). The groups were compared in terms of accurately predicting SVI positivity.

Results: Ninety (11.22%) patients were included in the study. All patients were positive for SVI, 80 patients (88.9%) had extraprostatic spread, 21 (23.3%) patients had lymph node (LN) invasion, and 20 (22.2%) patients did not undergo LN dissection. The rates of correctly predicting SVI positivity were 25.9%, 73.8%, 81% for Observer I, II, and III, respectively. The accuracy rate of Observer II and Observer III was significantly (p<0.05) higher than the Observer I group. The accuracy rate did not differ significantly (p>0.05) between Observer II and III groups.

Conclusion: The ability of mpMRI to detect local factors such as SVI is enhanced by the radiologist's experience, which has the potential to create significant differences in proper staging and treatment plans.