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Detectability of prostate cancer in different parts of the gland with 3-Tesla multiparametric magnetic resonance imaging: correlation with whole-mount histopathology

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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.

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Acknowledgements

We thank Libby Cone, MD, MA, from Edanz Group Japan (www.edanzediting.com/ac) for editing drafts of this manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Urology, Kyoto University Hospital, Kyoto, Japan

    Katsuhiro Ito, Shusuke Akamatsu, Naoki Terada, Toshinari Yamasaki, Takahiro Inoue, Osamu Ogawa & Takashi Kobayashi

  2. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan

    Akihiro Furuta & Akira Kido

  3. Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan

    Yuki Teramoto

  4. Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Osamu Ogawa

Authors
  1. Katsuhiro Ito
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Correspondence to Osamu Ogawa.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments. The protocol for this study has been approved by the institutional Review Board of Kyoto University (#R1581).

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Ito, K., Furuta, A., Kido, A. et al. Detectability of prostate cancer in different parts of the gland with 3-Tesla multiparametric magnetic resonance imaging: correlation with whole-mount histopathology. Int J Clin Oncol 25, 732–740 (2020). https://doi.org/10.1007/s10147-019-01587-8

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  • DOI: https://doi.org/10.1007/s10147-019-01587-8

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