PI-RADS version 2.1 for the evaluation of transition zone lesions: a practical guide for radiologists

2021 ◽  
Author(s):  
Caterina Gaudiano ◽  
Arianna Rustici ◽  
Beniamino Corcioni ◽  
Federica Ciccarese ◽  
Lorenzo Bianchi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Transition Zone ◽  
Peripheral Zone ◽  
Resonance Imaging ◽  
Prostate Imaging ◽  
Non Invasive ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Imaging Tool

Multiparametric magnetic resonance imaging has been established as the most accurate non-invasive diagnostic imaging tool for detecting prostate cancer (PCa) in both the peripheral zone and the transition zone (TZ) using the PI-RADS (Prostate Imaging Reporting and Data System) version 2.1 released in 2019 as a guideline to reporting. Transition zone PCa remains the most difficult to diagnose due to a markedly heterogeneous background and a wide variety of atypical imaging presentations as well as other anatomical and pathological processes mimicking PCa. The aim of this paper was to present a spectrum of PCa in the TZ, as a guide for radiologists.

scholarly journals Sensitivity of prostate cancer foci using 1.5 T multiparametric magnetic resonance imaging

2020 ◽  
Author(s):  
Suguru Ito ◽  
SEI NAITO ◽  
Takafumi Narisawa ◽  
Mayu Yagi ◽  
Yuta Kurota ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
False Negative ◽  
Resonance Imaging ◽  
Prostate Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Negative Results ◽  
False Negative Results ◽  
Clinically Significant

Abstract Background The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP. Methods A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥ 3 + 4 (GS ≥ 3 + 4 or diameter > 10 mm) and csCaP/GS ≥ 4 + 3 (GS ≥ 4 + 3 or diameter > 10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥ 3. Results The sensitivity of all legions, csCaP/GS ≥ 3 + 4, csCaP/GS ≥ 4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥ 3 + 4. There were three lesions with a GS of ≥ 8 and ≥ 10 mm in the false-negative results. Conclusions mpMRI can highly detect ITs and csCaP/GS ≥ 4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

Multiparametric magnetic resonance imaging of multifocal prostate cancer to reveal intra-prostatic genomic heterogeneity and novel radio-genomic correlates: Results of the Smarter Prostate Interventions and Therapeutics (SPIRIT) study.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 20-20
Author(s):  
Glenn Bauman ◽  
Rohann Correa ◽  
Erfan Aref-Eshghi ◽  
Ryan Alfano ◽  
Bekim Sadikovic ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Gleason Score ◽  
Peripheral Zone ◽  
Imaging Biomarker ◽  
Low Grade ◽  
Gleason Grade ◽  
Resonance Imaging ◽  
Multiparametric Magnetic Resonance Imaging

20 Background: Multi-focality and heterogeneity in prostate cancer can confound the selection of appropriate clinical management. Our study aimed to explore radio-genomic correlations using multiparametric magnetic resonance imaging (mpMRI) against a histopathologic reference standard. Methods: Eight men with prostate cancer who underwent mpMRI followed by prostatectomy were selected for this pilot. Whole-mount histopathology was digitized and co-registered to corresponding MRI slices using a validated high-fidelity methodology.(1) Foci, including central/transitional and peripheral zone lesions were identified by a pathologist, and contoured on digitized histopathology specimens and these digitized maps were used to guide macrodissection of the individual foci for genomic copy-number aberration (CNA) analysis. Correlation of radiomics signatures with the histologic findings and genomic analysis was performed. Results: We found a broad range of CNAs revealing inter-patient and intra-prostatic heterogeneity. Recurrently-altered loci ( e.g., 8p21) containing genes of known significance ( e.g., NKX3-1) were observed. Only radiomic features derived from apparent diffusion coefficient (ADC) independently correlated with both Gleason grade (Rho=-0.62, p=0.003) and median CNA burden (Rho=-0.68, p<0.001). While greater CNA burden expectedly correlated with higher grade, intermediate-grade (Gleason score 3+4 or 4+3) lesions appeared more like either high-grade (Gleason scores ≥4+4) or low-grade (Gleason score 3+3) disease when clustered based on CNA and ADC metrics. Conclusions: These findings suggest ADC derived radiomic metrics may be a useful imaging biomarker across both central and peripheral zone lesion and could aid in further characterization of intra-prostatic biologic heterogeneity. These proof-of-principle data reveal novel radio-genomic correlations that could supplement histologic grading and conventional imaging, thus warranting expanded study and validation. 1) Int J Rad Oncol Biol Phys. 2016; 96(1):188-96.

scholarly journals Multiparametric magnetic resonance imaging findings of prostatic pure leiomyomas

2016 ◽  
Vol 14 (3) ◽  
pp. 374-377 ◽  
Author(s):  
Thais Caldara Mussi ◽  
Yves Bohrer Costa ◽  
Marcos Takeo Obara ◽  
Marcos Roberto Gomes de Queiroz ◽  
Rodrigo Gobbo Garcia ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Imaging Features ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Imaging Methods ◽  
Multiparametric Magnetic Resonance Imaging

ABSTRACT Objective: To describe the imaging findings of prostatic tumors nonadenocarcinoma on multiparametric magnetic resonance imaging. Methods: A total of 200 patients underwented multiparametric magnetic resonance imaging of the prostate for screening for prostate cancer, from August 2013 to September 2014, followed by biopsy with ultrasound/magnetic resonance imaging fusion. Results: We found three pathologic proved cases of prostatic pure leiomyomas (0.02%) in our series and described the multiparametric magnetic resonance imaging features of these prostatic leiomyomas. The imaging findings had similar features to lesions with moderate or high suspicion for significant cancer (Likert 4 or 5) when localized both in the transitional zone or in the peripheral zone of the gland. Conclusion: Pure prostatic leiomyomas had imaging findings on multiparametric magnetic resonance imaging that mimicked usual adenocarcinomas on this test. Radiologists, urologists and pathologists must be aware of this entity and its imaging features.

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