INTRODUCTION: Prostatic ductal adenocarcinoma (DCa) is an aggressive variant. The purpose of this study was to determine if T2 signal intensity (SI) differs from conventional adenocarcinoma (CCa). MATERIALS AND METHODS: A retrospective study of patients who underwent preoperative MRI and prostatectomy between 2009 and 2012 was performed. T2 SI ratios (SIR) for tumour (T) to obturator internus muscle (M) and normal peripheral zone (PZ) were compared. Two radiologists evaluated the central gland/PZ to detect tumours and compared diagnostic accuracy. RESULTS: T2 SIR for DCa were 3.60 (T/M), 0.66 (T/PZ); 2.68 (T/M), 0.47 (T/PZ) for Gleason 9; 2.50 (T/M), 0.47 (T/PZ) for Gleason 7/8 and 3.95 (T/M), 0.73 (T/PZ) for Gleason 6 tumours. There was a difference in T2 T/M and T/PZ SIR between DCa and Gleason 9 (p = 0.003, p = 0.004) and Gleason 7/8 (p = 0.006, p = 0.002), but no difference in SIR between DCa and Gleason 6 tumours. The sensitivity for tumour detection was 0-27 % for DCa, 64-82 % for Gleason 9, 44-88 % for Gleason 7-8 and 0-20 % for Gleason 6. There was a difference in the sensitivity of detecting Gleason 9 and 7/8 tumours when compared to DCa (p = 0.004, p = 0.001). CONCLUSIONS: DCa resembles Gleason score 6 tumour at T2-weighted MRI, which underestimates tumour grade and renders the tumour occult. KEY POINTS: Prostatic ductal adenocarcinoma is aggressive, resembling endometrial carcinoma at histopathology. Prostatic ductal adenocarcinoma resembles Gleason score 6 tumour at T2-weighted MRI. MRI grading may underestimate ductal adenocarcinoma based on increased T2 signal.
INTRODUCTION:Prostatic ductal adenocarcinoma (DCa) is an aggressive variant. The purpose of this study was to determine if T2 signal intensity (SI) differs from conventional adenocarcinoma (CCa). MATERIALS AND METHODS: A retrospective study of patients who underwent preoperative MRI and prostatectomy between 2009 and 2012 was performed. T2 SI ratios (SIR) for tumour (T) to obturator internus muscle (M) and normal peripheral zone (PZ) were compared. Two radiologists evaluated the central gland/PZ to detect tumours and compared diagnostic accuracy. RESULTS: T2 SIR for DCa were 3.60 (T/M), 0.66 (T/PZ); 2.68 (T/M), 0.47 (T/PZ) for Gleason 9; 2.50 (T/M), 0.47 (T/PZ) for Gleason 7/8 and 3.95 (T/M), 0.73 (T/PZ) for Gleason 6 tumours. There was a difference in T2 T/M and T/PZ SIR between DCa and Gleason 9 (p = 0.003, p = 0.004) and Gleason 7/8 (p = 0.006, p = 0.002), but no difference in SIR between DCa and Gleason 6 tumours. The sensitivity for tumour detection was 0-27 % for DCa, 64-82 % for Gleason 9, 44-88 % for Gleason 7-8 and 0-20 % for Gleason 6. There was a difference in the sensitivity of detecting Gleason 9 and 7/8 tumours when compared to DCa (p = 0.004, p = 0.001). CONCLUSIONS:DCa resembles Gleason score 6 tumour at T2-weighted MRI, which underestimates tumour grade and renders the tumour occult. KEY POINTS: Prostatic ductal adenocarcinoma is aggressive, resembling endometrial carcinoma at histopathology. Prostatic ductal adenocarcinoma resembles Gleason score 6 tumour at T2-weighted MRI. MRI grading may underestimate ductal adenocarcinoma based on increased T2 signal.
Authors: Caroline M A Hoeks; Jelle O Barentsz; Thomas Hambrock; Derya Yakar; Diederik M Somford; Stijn W T P J Heijmink; Tom W J Scheenen; Pieter C Vos; Henkjan Huisman; Inge M van Oort; J Alfred Witjes; Arend Heerschap; Jurgen J Fütterer Journal: Radiology Date: 2011-10 Impact factor: 11.105
Authors: William Jackson; Daniel A Hamstra; Skyler Johnson; Jessica Zhou; Benjamin Foster; Corey Foster; Darren Li; Yeohan Song; Ganesh S Palapattu; Lakshmi P Kunju; Rohit Mehra; Felix Y Feng Journal: Cancer Date: 2013-07-02 Impact factor: 6.860
Authors: Peter Beddy; Ailbhe C O'Neill; Adam K Yamamoto; Helen C Addley; Caroline Reinhold; Evis Sala Journal: Radiographics Date: 2012 Jan-Feb Impact factor: 5.333
Authors: John V Hegde; Robert V Mulkern; Lawrence P Panych; Fiona M Fennessy; Andriy Fedorov; Stephan E Maier; Clare M C Tempany Journal: J Magn Reson Imaging Date: 2013-05 Impact factor: 4.813
Authors: Previn Gulavita; Shaheed W Hakim; Nicola Schieda; Rodney H Breau; Chris Morash; Daniel T Keefe; Susan J Robertson; Kien T Mai; Eric C Belanger; Trevor A Flood Journal: Can Urol Assoc J Date: 2015 Sep-Oct Impact factor: 1.862
Authors: Weranja Ranasinghe; Daniel D Shapiro; Miao Zhang; Tharakeswara Bathala; Nora Navone; Timothy C Thompson; Bradley Broom; Ana Aparicio; Shi-Ming Tu; Chad Tang; John W Davis; Louis Pisters; Brian F Chapin Journal: Nat Rev Urol Date: 2021-04-06 Impact factor: 14.432
Authors: Joseph M Norris; Lina M Carmona Echeverria; Simon R J Bott; Louise C Brown; Nick Burns-Cox; Tim Dudderidge; Ahmed El-Shater Bosaily; Eleni Frangou; Alex Freeman; Maneesh Ghei; Alastair Henderson; Richard G Hindley; Richard S Kaplan; Alex Kirkham; Robert Oldroyd; Chris Parker; Raj Persad; Shonit Punwani; Derek J Rosario; Iqbal S Shergill; Vasilis Stavrinides; Mathias Winkler; Hayley C Whitaker; Hashim U Ahmed; Mark Emberton Journal: Eur Urol Date: 2020-05-01 Impact factor: 20.096
Authors: Joseph M Norris; Lina M Carmona Echeverria; Benjamin S Simpson; Rhys Ball; Alex Freeman; Daniel Kelly; Alex Kirkham; Hayley C Whitaker; Mark Emberton Journal: BMJ Open Date: 2020-10-22 Impact factor: 2.692