Michelle R Downes1, Eli Gibson2, Jenna Sykes3, Masoom Haider4, Theo H van der Kwast5, Aaron Ward6. 1. Department of Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Electronic address: michelle.downes@sunnybrook.ca. 2. Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Biomedical Engineering Graduate Program, University of Western Ontario, London, Ontario, Canada. 3. Department of Biostatistics, St. Michael's Hospital, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, Canada. 4. Department of Radiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 5. Department of Pathology, University Health Network, Toronto, Ontario, Canada. 6. Departments of Medical Biophysics and Oncology, Biomedical Engineering Graduate Program, University of Western Ontario, Lawson Health Research Institute, London Regional Cancer Program, London, Ontario, Canada.
Abstract
RATIONALE AND OBJECTIVES: The study aimed to determine the relationship between T2-weighted magnetic resonance imaging (MRI) signal and histologic sub-patterns in prostate cancer areas with different Gleason grades. MATERIALS AND METHODS: MR images of prostates (n = 25) were obtained prior to radical prostatectomy. These were processed as whole-mount specimens with tumors and the peripheral zone was annotated digitally by two pathologists. Gleason grade 3 was the most prevalent grade and was subdivided into packed, intermediate, and sparse based on gland-to-stroma ratio. Large cribriform, intraductal carcinoma, and small cribriform glands (grade 4 group) were separately annotated but grouped together for statistical analysis. The log MRI signal intensity for each contoured region (n = 809) was measured, and pairwise comparisons were performed using the open-source software R version 3.0.1. RESULTS: Packed grade 3 sub-pattern has a significantly lower MRI intensity than the grade 4 group (P < 0.00001). Sparse grade 3 has a significantly higher MRI intensity than the packed grade 3 sub-pattern (P < 0.0001). No significant difference in MRI intensity was observed between the Gleason grade 4 group and the sparse sub-pattern grade 3 group (P = 0.54). In multivariable analysis adjusting for peripheral zone, the P values maintained significance (packed grade 3 group vs grade 4 group, P < 0.001; and sparse grade 3 sub-pattern vs packed grade 3 sub-pattern, P < 0.001). CONCLUSIONS: This study demonstrated that T2-weighted MRI signal is dependent on histologic sub-patterns within Gleason grades 3 and 4 cancers, which may have implications for directed biopsy sampling and patient management.
RATIONALE AND OBJECTIVES: The study aimed to determine the relationship between T2-weighted magnetic resonance imaging (MRI) signal and histologic sub-patterns in prostate cancer areas with different Gleason grades. MATERIALS AND METHODS: MR images of prostates (n = 25) were obtained prior to radical prostatectomy. These were processed as whole-mount specimens with tumors and the peripheral zone was annotated digitally by two pathologists. Gleason grade 3 was the most prevalent grade and was subdivided into packed, intermediate, and sparse based on gland-to-stroma ratio. Large cribriform, intraductal carcinoma, and small cribriform glands (grade 4 group) were separately annotated but grouped together for statistical analysis. The log MRI signal intensity for each contoured region (n = 809) was measured, and pairwise comparisons were performed using the open-source software R version 3.0.1. RESULTS: Packed grade 3 sub-pattern has a significantly lower MRI intensity than the grade 4 group (P < 0.00001). Sparse grade 3 has a significantly higher MRI intensity than the packed grade 3 sub-pattern (P < 0.0001). No significant difference in MRI intensity was observed between the Gleason grade 4 group and the sparse sub-pattern grade 3 group (P = 0.54). In multivariable analysis adjusting for peripheral zone, the P values maintained significance (packed grade 3 group vs grade 4 group, P < 0.001; and sparse grade 3 sub-pattern vs packed grade 3 sub-pattern, P < 0.001). CONCLUSIONS: This study demonstrated that T2-weighted MRI signal is dependent on histologic sub-patterns within Gleason grades 3 and 4 cancers, which may have implications for directed biopsy sampling and patient management.
Authors: Michele Scialpi; Pietro Scialpi; Eugenio Martorana; Riccardo Torre; Antonio Improta; Maria Cristina Aisa; Alfredo D'Andrea; Aldo Di Blasi Journal: Turk J Urol Date: 2021-05
Authors: Emanuel Darius Cata; Iulia Andras; Teodora Telecan; Attila Tamas-Szora; Radu-Tudor Coman; Dan-Vasile Stanca; Ioan Coman; Nicolae Crisan Journal: Med Pharm Rep Date: 2021-04-29