scholarly journals Incidental findings in and around the prostate on prostate MRI: a pictorial review

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Janki Trivedi ◽  
Tom Sutherland ◽  
Mark Page
Keyword(s):  
Prostate Cancer ◽  
Incidental Findings ◽  
Diagnostic Modality ◽  
Genitourinary System ◽  
Prostate Mri ◽  
Pictorial Review ◽  
Life Saving ◽  
Clinically Significant ◽  
Mri Characteristics

AbstractProstate MRI has seen rapid growth in use in recent years as an advanced diagnostic modality to detect focal areas of clinically significant prostate cancer, to identify an area for targeted biopsy and to guide management and surveillance. The increase in use has also led to increased diagnosis of incidental lesions arising from structures around the prostate. These incidental findings may be related to the genitourinary system or non- genitourinary system and may have a benign aetiology which needs no additional follow-up, or it may require surveillance and management. The field of view in a multiparametric prostate MRI includes other pelvic organs, neurovascular bundles, bowel, lymph nodes and bones. Being familiar with standard MRI characteristics and a sound knowledge of anatomy of the prostate and surrounding structures can help in distinguishing normal anatomy from pathology. Given that patients undertaking a prostate MRI are usually a cohort with increased anxiety from their known or suspicion of prostate cancer, it is important that radiologists are familiar with these common incidental findings to minimise anxiety to the patient, have a well-informed discussion with the referring clinician and reduce costs associated with unnecessary further testing and follow-up of benign incidental findings. Additionally, being able to diagnose more serious incidental pathologies early can be life-saving and potentially significantly alter patient management.

A PSA for Radiologists: Pictorial Review of Incidentalomas on Prostate Magnetic Resonance Imaging

2019 ◽  
Vol 70 (2) ◽  
pp. 134-146 ◽  
Author(s):  
Amanzo A. Ho ◽  
S. Sejal Khara ◽  
David J. Ferguson ◽  
Mohammed F. Mohammed ◽  
Silvia D. Chang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Incidental Findings ◽  
Imaging Study ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Patient Anxiety ◽  
Prostate Mri ◽  
Pictorial Review ◽  
Clinically Significant

Multiparametric magnetic resonance imaging (MRI) of the prostate is a powerful and increasingly utilized imaging study for the diagnosis, staging, and surveillance of prostate cancer. With greater adoption by clinicians, it is becoming more common for incidental findings to be first detected on prostate MRI. Inadequate description of clinically significant findings may not prompt appropriate patient management, while over-reporting of indolent findings comes at increased patient anxiety, cost of workup, and iatrogenic risk. This review article aims to improve awareness, review pathophysiology, and present key imaging features of incidental findings seen on prostate MRI, ranging from common to rare and from benign to clinically significant.

Imaging characteristics of patients with prostate cancer who discontinued active holistic surveillance on 3T multiparametric prostate MRI.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 18-18
Author(s):  
Aaron Katz ◽  
Corinne Liu ◽  
Andrew S Fontes ◽  
Kaitlin E. Kosinski
Keyword(s):  
Prostate Cancer ◽  
Early Stage ◽  
Definitive Treatment ◽  
Vitamin Supplements ◽  
Prostate Mri ◽  
Special Diet ◽  
Imaging Characteristics ◽  
Multiparametric Prostate Mri ◽  
Clinically Significant

18 Background: Early-stage patients with prostate cancer can decide to go on Active Holistic Surveillance (AHS) to avoid over-treatment of a disease that has a high probability of being indolent. These patients are also placed on a special diet with vitamin supplements. We evaluate the imaging characteristics of this particular set of patients with prostate cancer with early-stage disease who are on a special diet and vitamin supplements, discontinued AHS and received definitive treatment. Methods: 300 consecutive 3T Multiparametric Prostate MRI (MP-MRI) were identified from March 26, 2012, to June 29, 2015. 200 patients (age 44 to 84 years) were identified in the active surveillance program. 114 patients had an initial MP-MRI prior to starting AHS and had at least one follow up MP-MRI after beginning AHS. 14 (12%) patients (age 60 to 79 years) discontinued AHS due to changes on a follow up MRI suggesting clinically significant prostate cancer. The MRI imaging findings were evaluated and correlated with pathology results, if available. Results: Of 14 patients, 3 (21%) patients had an enlarging MRI lesion compared to a previous MRI, 2 (14 %) patients had a new MRI lesion(s) suspicious for cancer, and 9 (64%) patients had suspicion or confirmation of extracapsular extension. 7 (50%) patients had a biopsy after a follow up MP-MRI with 6 (43%) demonstrating tumor upgrading. Length of time on AHS ranged from 4 months to 110 months. Prostate-specific antigen (PSA) levels and PSA density prior to beginning AHS ranged from 4.8 to 12.0 and 0.04 to 0.39, respectively. All were treated with definitive treatment, majority with unilateral focal cryoablation. Conclusions: The small number of patients with worsening disease on follow-up MP-MRI supports the role of AHS in patients with early-stage prostate cancer. MP-MRI is a useful tool in following patients on AHS and can extract patients who potentially may have clinically significant cancer and who may benefit from definitive treatment.

scholarly journals Whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in prostate cancer: Prevalence and clinical significance of incidental findings

2021 ◽  
pp. 20210459
Author(s):  
Soma Kumasaka ◽  
Shunichi Motegi ◽  
Yuka Kumasaka ◽  
Tatsuya Nishikata ◽  
Masami Otomo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Incidental Findings ◽  
Whole Body ◽  
Whole Body Imaging ◽  
Resonance Imaging ◽  
Body Imaging ◽  
Signal Suppression ◽  
Body Magnetic Resonance Imaging ◽  
Clinically Significant

Objective: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) is now recommended as a first-line staging modality in prostate cancer patients, and the widespread use of DWIBS may lead to an increased frequency of incidental findings. The aim of this study was to evaluate the prevalence and clinical significance of incidental findings on whole-body magnetic resonance imaging (WB-MRI) with DWIBS. Methods: Data from 124 patients with prostate cancer (age, 76.5 ± 5.6 years), who underwent 1.5 T WB-MRI with STIR, TSE-T2, TSE-T1, In/Out GRE, and DWIBS sequences, were retrospectively analyzed. Findings unrelated to prostate cancer were considered as incidental findings and categorized into two groups based on their clinical implications, as follow: imaging follow-up or additional examinations was required (significant incidental findings) and no need to additional work-up (non-significant incidental findings). A Chi-square test was performed to compare the differences in the prevalence of significant incidental findings based on age (≤75 and>75 years old). Results: A total of 334 incidental findings were found, with 8.1% (n = 27) as significant incidental findings. Significant incidental findings were more frequent in patients over 75 years old than those of 75 years old or younger (28.6% vs  11.1%, p = 0.018). Conclusion: Clinically significant incidental findings, which required imaging follow-up or additional examinations, were commonly observed in prostate cancer patients on WB-MRI/DWIBS. Advances in knowledge: Some incidental findings were clinically significant which may lead to changes in treatment strategy. Checking the entire organ carefully for abnormalities, and reporting any incidental findings detected are important.

scholarly journals Is possible to rule out clinically significant prostate cancer using PI-RADS v2 for the assessment of prostate MRI?

2019 ◽  
Vol 45 (4) ◽  
pp. 724-731
Author(s):  
Publio Cesar Cavalcanti Viana ◽  
Natally Horvat ◽  
Valter Ribeiro dos Santos Júnior ◽  
Thais Carneiro Lima ◽  
Davi dos Santos Romão ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Mri ◽  
Clinically Significant ◽  
Rule Out

scholarly journals Clinically significant incidental findings during preoperative computed tomography of patients undergoing cardiac surgery

2020 ◽  
Vol 31 (5) ◽  
pp. 629-631
Author(s):  
Davorin Sef ◽  
Inderpaul Birdi
Keyword(s):  
Computed Tomography ◽  
Cardiac Surgery ◽  
Incidental Findings ◽  
Preoperative Assessment ◽  
Female Gender ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Clinically Significant ◽  
Work Up

Abstract With the development of minimally invasive cardiac surgery, chest and abdominal computed tomography (CT) scans are becoming an integral part of preoperative assessment and planning. Therefore, the number of incidental findings (IFs) detected with CT is rising. We aimed to investigate the frequency of clinically significant IFs on chest and abdominal CT scans performed during the preoperative assessment of patients undergoing adult cardiac surgery in a 2-year period. In a cohort of 401 patients (mean age 67.4 ± 12.3, female gender 28.9%, median logistic EuroSCORE 5.8 [0.9, 90.5]) who underwent chest or abdominal CT imaging during the study period, we identified 75 patients (18.7%) with clinically significant IFs who needed a further treatment or work-up to confirm the diagnosis or postoperative follow-up. Our data indicate that clinically significant IFs in patients referred for cardiac surgery are frequent. It is important to identify clinically significant Ifs, as a clear postoperative follow-up plan should be made.

scholarly journals Development and validation of a 25-Gene Panel urine test for prostate cancer diagnosis and potential treatment follow-up

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Heather Johnson ◽  
Jinan Guo ◽  
Xuhui Zhang ◽  
Heqiu Zhang ◽  
Athanasios Simoulis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cancer Diagnosis ◽  
Multivariate Logistic Regression Analysis ◽  
Gene Panel ◽  
Urine Test ◽  
Non Invasive ◽  
Clinically Significant ◽  
Benign Prostate

Abstract Background Heterogeneity of prostate cancer (PCa) contributes to inaccurate cancer screening and diagnosis, unnecessary biopsies, and overtreatment. We intended to develop non-invasive urine tests for accurate PCa diagnosis to avoid unnecessary biopsies. Methods Using a machine learning program, we identified a 25-Gene Panel classifier for distinguishing PCa and benign prostate. A non-invasive test using pre-biopsy urine samples collected without digital rectal examination (DRE) was used to measure gene expression of the panel using cDNA preamplification followed by real-time qRT-PCR. The 25-Gene Panel urine test was validated in independent multi-center retrospective and prospective studies. The diagnostic performance of the test was assessed against the pathological diagnosis from biopsy by discriminant analysis. Uni- and multivariate logistic regression analysis was performed to assess its diagnostic improvement over PSA and risk factors. In addition, the 25-Gene Panel urine test was used to identify clinically significant PCa. Furthermore, the 25-Gene Panel urine test was assessed in a subset of patients to examine if cancer was detected after prostatectomy. Results The 25-Gene Panel urine test accurately detected cancer and benign prostate with AUC of 0.946 (95% CI 0.963–0.929) in the retrospective cohort (n = 614), AUC of 0.901 (0.929–0.873) in the prospective cohort (n = 396), and AUC of 0.936 (0.956–0.916) in the large combination cohort (n = 1010). It greatly improved diagnostic accuracy over PSA and risk factors (p < 0.0001). When it was combined with PSA, the AUC increased to 0.961 (0.980–0.942). Importantly, the 25-Gene Panel urine test was able to accurately identify clinically significant and insignificant PCa with AUC of 0.928 (95% CI 0.947–0.909) in the combination cohort (n = 727). In addition, it was able to show the absence of cancer after prostatectomy with high accuracy. Conclusions The 25-Gene Panel urine test is the first highly accurate and non-invasive liquid biopsy method without DRE for PCa diagnosis. In clinical practice, it may be used for identifying patients in need of biopsy for cancer diagnosis and patients with clinically significant cancer for immediate treatment, and potentially assisting cancer treatment follow-up.

Improved Detection of Clinically Significant Prostate Cancer With Software-assisted Systematic Biopsy Using MR/US Fusion in Patients With Negative Prostate MRI

Urology ◽  
2018 ◽  
Vol 120 ◽  
pp. 162-166 ◽  
Author(s):  
Yifan Meng ◽  
Joel M. Vetter ◽  
Alexander A. Parker ◽  
Christopher T. Arett ◽  
Gerald L. Andriole ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Mri ◽  
Clinically Significant ◽  
Systematic Biopsy

scholarly journals How to read biparametric MRI in men with a clinical suspicious of prostate cancer: Pictorial review for beginners with public access to imaging, clinical and histopathological database

2021 ◽  
Vol 10 (11) ◽  
pp. 205846012110607
Author(s):  
Ivan Jambor ◽  
Alberto Martini ◽  
Ugo G Falagario ◽  
Otto Ettala ◽  
Pekka Taimen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Contrast Agent ◽  
Clinical Suspicion ◽  
Public Access ◽  
Solid Base ◽  
Large Array ◽  
Medical Providers ◽  
Prostate Mri ◽  
Scan Time ◽  
Pictorial Review

Prostate Magnetic Resonance Imaging (MRI) is increasingly being used in men with a clinical suspicion of prostate cancer (PCa). Performing prostate MRI without the use of an intravenous contrast (IV) agent in men with a clinical suspicion of PCa can lead to reduced MRI scan time. Enabling a large array of different medical providers (from mid-level to specialized radiologists) to evaluate and potentially report prostate MRI in men with a clinical suspicion of PCa with a high accuracy could be one way to enable wide adoption of prostate MRI in men with a clinical suspicion of PCa. The aim of this pictorial review is to provide an insight into acquisition, quality control and reporting of prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa, aimed specifically at radiologists starting reporting prostate MRI, urologists, urology/radiology residents and mid-level medical providers without experience in reporting prostate MRI. Free public access ( http://petiv.utu.fi/improd/ and http://petiv.utu.fi/multiimprod/ ) to complete datasets of 161 and 338 men is provided. The imaging datasets are accompanied by clinical, laboratory and histopathological findings. Several topics are simplified in order to provide a solid base for the development of skills needed for an unsupervised review and potential reporting of prostate MRI in men with a clinical suspicion of PCa. The current review represents the first step towards enabling a large array of different medical providers to review and report accurately prostate MRI performed without IV contrast agent in men with a clinical suspicion of PCa.

Sign in / Sign up

Export Citation Format

Share Document