Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy
BackgroundPositive surgical margins (PSMs) are an independent risk factor of biochemical recurrence in patients with prostate cancer (PCa) after laparoscopic radical prostatectomy; however, limited MRI-based predictive tools are available. This study aimed to develop a novel nomogram combining clini...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.973285/full |
| _version_ | 1811273448591196160 |
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| author | Shuang Meng Lihua Chen Qinhe Zhang Nan Wang Ailian Liu |
| author_facet | Shuang Meng Lihua Chen Qinhe Zhang Nan Wang Ailian Liu |
| author_sort | Shuang Meng |
| collection | DOAJ |
| description | BackgroundPositive surgical margins (PSMs) are an independent risk factor of biochemical recurrence in patients with prostate cancer (PCa) after laparoscopic radical prostatectomy; however, limited MRI-based predictive tools are available. This study aimed to develop a novel nomogram combining clinical and multiparametric MRI (mpMRI) parameters to reduce PSMs by improving surgical planning.MethodsOne hundred and three patients with PCa (55 patients with negative surgical margins [NSMs] and 48 patients with PSMs) were included in this retrospective study. The following parameters were obtained using GE Functool post-processing software: diffusion-weighted imaging (DWI); intravoxel incoherent motion model (IVIM); and diffusion kurtosis imaging (DKI). Patients were divided into different training sets and testing sets for different targets according to a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression algorithm was used to analyze the data set to select the optimal MRI predictors. Preoperatively clinical parameters used to build a clinical nomogram (C-nomogram). Multivariable logistic regression analysis was used to build an MRI nomogram (M-nomogram) by introducing the MRI parameters. Based on the MRI and clinical parameters, build an MRI combined with clinical parameters nomogram (MC-nomogram). Comparisons with the M-nomogram and MC-nomogram were based on discrimination, calibration, and decision curve analysis (DCA). A 3-fold cross-validation method was used to assess the stability of the nomogram.ResultsThere was no statistical difference in AUC between the C-nomogram (sensitivity=64%, specificity=65% and AUC=0.683), the M-nomogram (sensitivity=57%, specificity=88% and AUC=0.735) and the MC-nomogram (sensitivity= 64%, specificity=82% and AUC=0.756). The calibration curves of the three nomograms used to predict the risk of PSMs in patients with PCa showed good agreement. The net benefit of the MC-nomogram was higher than the others (range, 0.2-0.7).ConclusionsThe mpMRI-based nomogram can predict PSMs in PCa patients. Although its AUC (0.735) is not statistically different from that of the clinical-based nomogram AUC (0.683). However, mpMRI-based nomogram has higher specificity (88% VS. 63%), model stability, and clinical benefit than clinical-based nomogram. And the predictive ability of mpMRI plus clinical parameters for PSMs is further improved. |
| first_indexed | 2024-04-12T23:00:20Z |
| format | Article |
| id | doaj.art-942e42a810074039b6486f42b739470a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T23:00:20Z |
| publishDate | 2022-09-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-942e42a810074039b6486f42b739470a2022-12-22T03:13:05ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.973285973285Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomyShuang MengLihua ChenQinhe ZhangNan WangAilian LiuBackgroundPositive surgical margins (PSMs) are an independent risk factor of biochemical recurrence in patients with prostate cancer (PCa) after laparoscopic radical prostatectomy; however, limited MRI-based predictive tools are available. This study aimed to develop a novel nomogram combining clinical and multiparametric MRI (mpMRI) parameters to reduce PSMs by improving surgical planning.MethodsOne hundred and three patients with PCa (55 patients with negative surgical margins [NSMs] and 48 patients with PSMs) were included in this retrospective study. The following parameters were obtained using GE Functool post-processing software: diffusion-weighted imaging (DWI); intravoxel incoherent motion model (IVIM); and diffusion kurtosis imaging (DKI). Patients were divided into different training sets and testing sets for different targets according to a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression algorithm was used to analyze the data set to select the optimal MRI predictors. Preoperatively clinical parameters used to build a clinical nomogram (C-nomogram). Multivariable logistic regression analysis was used to build an MRI nomogram (M-nomogram) by introducing the MRI parameters. Based on the MRI and clinical parameters, build an MRI combined with clinical parameters nomogram (MC-nomogram). Comparisons with the M-nomogram and MC-nomogram were based on discrimination, calibration, and decision curve analysis (DCA). A 3-fold cross-validation method was used to assess the stability of the nomogram.ResultsThere was no statistical difference in AUC between the C-nomogram (sensitivity=64%, specificity=65% and AUC=0.683), the M-nomogram (sensitivity=57%, specificity=88% and AUC=0.735) and the MC-nomogram (sensitivity= 64%, specificity=82% and AUC=0.756). The calibration curves of the three nomograms used to predict the risk of PSMs in patients with PCa showed good agreement. The net benefit of the MC-nomogram was higher than the others (range, 0.2-0.7).ConclusionsThe mpMRI-based nomogram can predict PSMs in PCa patients. Although its AUC (0.735) is not statistically different from that of the clinical-based nomogram AUC (0.683). However, mpMRI-based nomogram has higher specificity (88% VS. 63%), model stability, and clinical benefit than clinical-based nomogram. And the predictive ability of mpMRI plus clinical parameters for PSMs is further improved.https://www.frontiersin.org/articles/10.3389/fonc.2022.973285/fullprostate cancerpositive surgical marginsMRInomogramlaparoscopic radical prostatectomy |
| spellingShingle | Shuang Meng Lihua Chen Qinhe Zhang Nan Wang Ailian Liu Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy Frontiers in Oncology prostate cancer positive surgical margins MRI nomogram laparoscopic radical prostatectomy |
| title | Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| title_full | Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| title_fullStr | Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| title_full_unstemmed | Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| title_short | Multiparametric MRI-based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| title_sort | multiparametric mri based nomograms in predicting positive surgical margins of prostate cancer after laparoscopic radical prostatectomy |
| topic | prostate cancer positive surgical margins MRI nomogram laparoscopic radical prostatectomy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.973285/full |
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