• Jing Wang, Chen-Jiang Wu, Mei-Ling Bao, Jing Zhang, Hai-Bin Shi, and Yu-Dong Zhang.
• Center for Medical Device Evaluation, CFDA, Beijing, China.
• J Magn Reson Imaging. 2018 Aug 1; 48 (2): 499-506.

BackgroundPartin tables represent the most widely used predictive tool for prostate cancer stage at prostatectomy but with potential limitations.PurposeTo develop a new PartinMR model for organ-confined prostate cancer (OCPCA) by incorporating Partin table and mp-MRI with a support vector machine (SVM) analysis.Study TypeRetrospective.PopulationIn all, 541 patients with biopsy-confirmed prostate cancer underwent mp-MRI.Field StrengthT2 -weighted, diffusion-weighted imaging with a 3.0T MR scanner.AssessmentCandidate predictors included age, prostate-specific antigen, clinical stage, biopsy Gleason score (GS), and mp-MRI findings, ie, tumor location, Prostate Imaging and Reporting and Data System (PI-RADS) score, diameter (D-max), and 6-point MR stage. The PartinMR model with combination of a Partin table and mp-MRI findings was developed using SVM and 5-fold crossvalidation analysis.Statistical TestsThe predicted ability of the PartinMR model was compared with a standard Partin and a modified Partin table (mPartin) which used for mp-MRI staging. Statistical tests were made by area under receiver operating characteristic curve (AUC), adjusted proportional hazard ratio (HR), and a cost-effective benefit analysis.ResultsThe rate of OCPCA at prostatectomy was 46.4% (251/541). Using MR staging, mPartin table (AUC, 0.814, 95% confidence interval [CI]: 0.779-0.846, P = 0.001) is appreciably better than the Partin table (AUC, 0.730, 95% CI: 0.690-0.767). Contrarily, adding all MR variables, the PartinMR model (AUC, 0.891, 95% CI: 0.884-0.899, P < 0.001) outperformed any other scheme, with 79.3% sensitivity, 75.7% specificity, 79% positive predictive value, and 76.0% negative predictive value for OCPCA. MR stage represented the most influential predictor of extracapsular extension (HR, 2.77, 95% CI: 1.54-3.33), followed by D-max (2.01, 95% CI: 1.31-2.68), biopsy GS (1.64, 95% CI: 1.35-2.12), and PI-RADS score (1.21, 95% CI: 1.01-1.98).Data ConclusionThe new PartinMR model is superior to the conventional Partin table for OCPCA. Clinical implications of mp-MRI for prostate cancer stage must be confirmed in further trials.Level Of Evidence3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:499-506.© 2018 International Society for Magnetic Resonance in Medicine.

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