Multidimensional analysis of clinicopathological characteristics of false-negative clinically significant prostate cancers on multiparametric MRI of the prostate in Japanese men
To clarify clinicopathological features of false-negative clinically significant prostate cancer (csPC) at multiparametric prostate MRI (mpMRI).
95 patients with 139 csPC undergoing 3T mpMRI before radical prostatectomy were included. Two radiologists were independently evaluated mpMR images using PI-RADS v2. Clinicopathological findings were compared between (a) detectable and undetectable lesions using overall mpMRI criteria (o-mpMRI criteria) and (b) lesions with early enhancement effect (EEE) and lesions without EEE at DCE-MRI.
The detection rate of csPS using cutoff value of category 3 or more in PI-RADS v2 for positive lesion was 72.1% (98/136 lesions). In 38 false-negative lesions with less than PI-RADS v2 category 3, the DCE-MRI detected 14 lesions. 17 undetectable lesions on o-mpMR criteria had lower PSA and D’amico risk classification, and higher tumor apparent diffusion coefficient (ADC) than those of 118 detectable lesions (p ≤ 0.048). 89 lesions with EEE showed higher PSA, tumor size, prostatectomy GS grade, frequency of lesions with GS ≥ 4 + 3 and lower tumor ADC than those in 38 lesions without EEE (p ≤ 0.046).
Tumor detectability of csPC with PI-RADS v2 was limited compared with o-mpMRI criteria in Japanese men. Moreover, false-negative lesions on o-mpMRI criteria were characterized as small in size, low risk and low cellularity.
KeywordsMagnetic resonance imaging Prostate cancer Tumor detection Prostate imaging and reporting data system version 2 Dynamic contrast-enhanced MR imaging
This study was supported by the Kawasaki Medical School Project; Contract Grant Number: 29B-044.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interests to disclose.
This single-center retrospective study was approved by the local institutional review board with a waiver of the requirement for written, informed consent.
- 1.American Cancer Society. Cancer facts and figures 2017. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf#search=%271.+American+Cancer+Society+%282017%29+Cancer+facts+and+figures+2017.%27. Accessed 29 March 2018.
- 2.Center for Cancer Control and Information Services, National Cancer Center Japan. Projected Cancer Statistics, 2017. https://ganjoho.jp/en/public/statistics/short_pred.html. Accessed 28 March 2018.
- 22.Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA, Grading Committee. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40:244–52.PubMedGoogle Scholar
- 24.Tamada T, Sone T, Higashi H, Jo Y, Yamamoto A, Kanki A, et al. Prostate cancer detection in patients with total serum prostate-specific antigen levels of 4–10 ng/mL: diagnostic efficacy of diffusion-weighted imaging, dynamic contrast-enhanced MRI, and T2-weighted imaging. AJR Am J Roentgenol. 2011;197:664–70.CrossRefGoogle Scholar
- 27.Cash H, Günzel K, Maxeiner A, Stephan C, Fischer T, Durmus T, et al. Prostate cancer detection on transrectal ultrasonography-guided random biopsy despite negative real-time magnetic resonance imaging/ultrasonography fusion-guided targeted biopsy: reasons for targeted biopsy failure. BJU Int. 2016;118:35–43.CrossRefGoogle Scholar
- 33.De Cobelli F, Ravelli S, Esposito A, Giganti F, Gallina A, Montorsi F, et al. Apparent diffusion coefficient value and ratio as noninvasive potential biomarkers to predict prostate cancer grading: comparison with prostate biopsy and radical prostatectomy specimen. AJR Am J Roentgenol. 2015;204:550–7.CrossRefGoogle Scholar
- 36.Tamada T, Kanomata N, Sone T, Jo Y, Miyaji Y, Higashi H, et al. High b value (2,000 s/mm2) diffusion-weighted magnetic resonance imaging in prostate cancer at 3 Tesla: comparison with 1,000 s/mm2 for tumor conspicuity and discrimination of aggressiveness. PLoS One. 2014;9:e96619.CrossRefGoogle Scholar