MRI and 11C acetate PET/CT for prediction of regional lymph node metastasis in newly diagnosed prostate cancer

Figures & Tables

Model Model one through ten: presented with OR (95%CI), p-value.	M1	M2	M3	M4	M5	M6	M7	M8	M9	M10
	3.7	4.1	8.4	2.7
LN-ADCmean 10^-6 mm2 /s	(1.1–13.3),	(1.1–14.7),	(1.8–39.0),	(0.8–9.5),
	0.040	0.032	0.007	0.110
	5.6				2.7	4.7	2.3
LN-SUVmax	(1.5–20.6),				(0.6-11.1),	(1.1-20.5),	(0.5-10.7),
	0.010				0.179	0.040	0.30
		5.7			3.7			6.2	2.8
LN-shape		(1.5–21.2),			(0.9–15.0),			(1.4–27.2),	(0.5–14.7),
		0.010			0.069			0.016	0.226
			6.8			5.3		3.9		4.5
MRI T-stage T3b T3a is not presented in the table, this is because it is not significant in any of the ten models above. / ≤ T2			(1.1–41.6),			(1.0–28.6),		(0.7–22.0),		(0.8–25.2),
			0.039			0.051		0.126		0.083
				7.5			4.8		3.8	9.3
LN-size mm				(1.4–40.3),			(0.7-34.7),		(0.4-31.6),	(1.4-61.1),
				0.018			0.116)		0.224	0.020

Nagelkerke’s R² Psedo R²	0.27	0.30	0.39	0.26	0.24	0.29	0.22	0.33	0.23	0.34
AUC	0.75	0.76	0.81	0.73	0.71	0.75	0.68	0.79	0.71	0.75
Sensitivity	72	74	67	83	63	65	68	74	74	74
Specificity	68	68	77	65	66	72	65	83	68	73
PPV	52	56	80	40	60	75	52	85	56	70
NPV	83	82	62	93	68	62	79	71	82	76
Cramers’V Multicollinearity	0.09	0.15	0.16	0.25	0.54	0.28	0.66	0.37	0.72	0.34
Accuracy	69	70	71	69	64	68	66	78	70	73

MRI DWI and ¹¹C Acetate PET/CT findings
LN-ADCmean 10^-6 mm² /s, mean (SD) range	917 (191) 582–1398
LN-SUVmax, mean (SD) range	1.8 (1.2) 0.7–5.9
LN size mm, mean (SD) range	6.6 (3.7) 3.8–28.3
Proportion of LNs with round shape, n	19
Proportion of LNs with oval shape, n	34
MRI T-stage, n
< T3	25
T3a	14
T3b	14
LN ADC Roi size mm², median (range)	42 (16–334)
Tumor ADC Roi size mm²	≥ 80

	N0 n	N1 n	OR	95%CI	p-value	Threshold	AUC	Pseudo R² Nagelkerke’s R²	Sensitivity/Specificity/PPV/NPV
LN-ADCmean 10^-6 mm² /s	21	19	3.6	1.1-11.6	0.031	≤ 800	0.65	0.12	58/73/76/53
LN-SUVmax	28	25	5.4	1.6-18.7	0.008	≥ 1.6	0.68	0.18	72/68/52/83
LN-size mm	28	25	8.7	1.7–44.9	0.010	≥ 7.9	0.66	0.20	83/63/40/93
LN round shape	5	14	5.9	1.7-20.4	0.006		0.69	0.20	74/68/56/82
LN oval shape	23	11	ref	ref	ref	ref	ref	ref	ref
MRI-T-stage
≤ T2	18	7	ref	ref	ref	ref	ref	ref	ref
T3a	7	7	2.00	0.4-10.5	0.412
T3b	3	11	6.0	1.2-29.4	0.027		0.69	0.17	65/67/65/67

Patient characteristics
Patients, n	53
Age, median (range)	68 (55–76)
LN positive patients, n	26
PSA level ng/ml, mean (median, range)	24 (19, 3–112)
Biopsy Gleason score, n (%)
6	5 (9.4)
7	39 (73.6)
8	5 (9.4)
9	4 (7.5)
D’Amico risk classification, n (%)
Intermediate	6 (11.3)
High	47 (88.7)
Clincal T-stage, n (%)
T1c	1 (1.9)
T2	11 (20.8)
T3	41 (77.4)
Risk of LN invasion Calculated according to Briganti nomogram (26) , n
19–59%	27
≥ 60%	26