Katsuhiro Ito1, Akihiro Furuta2, Akira Kido2, Yuki Teramoto3, Shusuke Akamatsu1, Naoki Terada1, Toshinari Yamasaki1, Takahiro Inoue1, Osamu Ogawa4,5, Takashi Kobayashi1. 1. Department of Urology, Kyoto University Hospital, Kyoto, Japan. 2. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan. 3. Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan. 4. Department of Urology, Kyoto University Hospital, Kyoto, Japan. ogawao@kuhp.kyoto-u.ac.jp. 5. Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. ogawao@kuhp.kyoto-u.ac.jp.
Abstract
BACKGROUND: We investigated whether the detectability of prostate cancer with 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) differs by tumor location. METHODS: We identified 136 patients with prostate cancer who underwent 3-T mpMRI before prostatectomy at a single academic center. Two uroradiologists scored all MRIs with Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2). A genitourinary pathologist mapped tumor foci from serial whole-mount radical prostatectomy sections. We assessed concordance of images with cancer sites. Tumor foci with Gleason score ≥ 3 + 4 or volume ≥ 0.5 mL were considered significant. RESULTS: A total of 122 foci in 106 cases were identified with mpMRI. Twenty-four were PI-RADS 3, 52 were 4, and 46 were 5. A total of 274 tumor foci were identified with whole-mount pathology. The sensitivity stratified by location to detect significant cancer with a PI-RADS cutoff value of 3 was 56.0% overall, 50.0% in the peripheral zone (PZ), 71.2% in the transitional zone (TZ), 62.4% anterior, 49.5% posterior, 42.0% apical, 63.6% in the midgland, and 43.8% in the gland base. In multivariate analysis, tumor location was not a significant predictor of identification by mpMRI. Tumor volume, Gleason score, and index tumor status were significantly associated with identification by mpMRI. CONCLUSIONS: mpMRI detected the majority of high-grade and large cancers, but had low sensitivity in the PZ, posterior, and apex and base of the gland. The high prevalence of low-volume, low-Gleason score index tumors, as well as satellite tumors in those areas, accounted for the difference.
BACKGROUND: We investigated whether the detectability of prostate cancer with 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) differs by tumor location. METHODS: We identified 136 patients with prostate cancer who underwent 3-T mpMRI before prostatectomy at a single academic center. Two uroradiologists scored all MRIs with Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2). A genitourinary pathologist mapped tumor foci from serial whole-mount radical prostatectomy sections. We assessed concordance of images with cancer sites. Tumor foci with Gleason score ≥ 3 + 4 or volume ≥ 0.5 mL were considered significant. RESULTS: A total of 122 foci in 106 cases were identified with mpMRI. Twenty-four were PI-RADS 3, 52 were 4, and 46 were 5. A total of 274 tumor foci were identified with whole-mount pathology. The sensitivity stratified by location to detect significant cancer with a PI-RADS cutoff value of 3 was 56.0% overall, 50.0% in the peripheral zone (PZ), 71.2% in the transitional zone (TZ), 62.4% anterior, 49.5% posterior, 42.0% apical, 63.6% in the midgland, and 43.8% in the gland base. In multivariate analysis, tumor location was not a significant predictor of identification by mpMRI. Tumor volume, Gleason score, and index tumor status were significantly associated with identification by mpMRI. CONCLUSIONS: mpMRI detected the majority of high-grade and large cancers, but had low sensitivity in the PZ, posterior, and apex and base of the gland. The high prevalence of low-volume, low-Gleason score index tumors, as well as satellite tumors in those areas, accounted for the difference.
Entities:
Keywords:
Diagnosis; Magnetic resonance imaging; Prostate cancer
Authors: Matthew D Greer; Anna M Brown; Joanna H Shih; Ronald M Summers; Jamie Marko; Yan Mee Law; Sandeep Sankineni; Arvin K George; Maria J Merino; Peter A Pinto; Peter L Choyke; Baris Turkbey Journal: J Magn Reson Imaging Date: 2016-07-08 Impact factor: 4.813
Authors: Maximilian Seles; Thomas Gutschi; Katrin Mayrhofer; Katja Fischereder; Georg Ehrlich; Guenter Gallé; Stefan Gutschi; Oliver Pachernegg; Karl Pummer; Herbert Augustin Journal: BJU Int Date: 2015-05-14 Impact factor: 5.588
Authors: Armando Stabile; Paolo Dell'Oglio; Francesco De Cobelli; Antonio Esposito; Giorgio Gandaglia; Nicola Fossati; Giorgio Brembilla; Giulia Cristel; Gianpiero Cardone; Federico Deho'; Andrea Losa; Nazareno Suardi; Franco Gaboardi; Alessandro Del Maschio; Francesco Montorsi; Alberto Briganti Journal: Eur Urol Oncol Date: 2018-05-15
Authors: Alan Priester; Shyam Natarajan; Pooria Khoshnoodi; Daniel J Margolis; Steven S Raman; Robert E Reiter; Jiaoti Huang; Warren Grundfest; Leonard S Marks Journal: J Urol Date: 2016-07-30 Impact factor: 7.450
Authors: Jeffrey W Nix; Baris Turkbey; Anthony Hoang; Dmitry Volkin; Nitin Yerram; Celene Chua; W Marston Linehan; Bradford Wood; Peter Choyke; Peter A Pinto Journal: BJU Int Date: 2012-10-04 Impact factor: 5.588
Authors: Nazanin Hajarol Asvadi; Sohrab Afshari Mirak; Amirhossein Mohammadian Bajgiran; Pooria Khoshnoodi; Pornphan Wibulpolprasert; Daniel Margolis; Anthony Sisk; Robert E Reiter; Steven S Raman Journal: Abdom Radiol (NY) Date: 2018-11
Authors: Stijn W T P J Heijmink; Jurgen J Fütterer; Thomas Hambrock; Satoru Takahashi; Tom W J Scheenen; Henkjan J Huisman; Christina A Hulsbergen-Van de Kaa; Ben C Knipscheer; Lambertus A L M Kiemeney; J Alfred Witjes; Jelle O Barentsz Journal: Radiology Date: 2007-05-10 Impact factor: 11.105
Authors: Joseph A Smith; Robert C Chan; Sam S Chang; S Duke Herrell; Peter E Clark; Roxy Baumgartner; Michael S Cookson Journal: J Urol Date: 2007-10-22 Impact factor: 7.450