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Prevalence and clinical significance of incidental findings on multiparametric prostate MRI

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Abstract

Purpose

To assess the prevalence and clinical significance of incidental findings (IFs) detected at multiparametric prostate MRI examination.

Materials and methods

Multiparametric prostate MRIs of 647 consecutive patients (mean age 67.1 ± 8.0 years) were retrospectively evaluated by two radiologists recording the presence of all extra-prostatic IFs. Findings were classified as related to or not related to genitourinary system and divided into three classes, according to their clinical significance, as follows: group 1, not significant or scarcely significant; group 2, moderately or potentially significant; and group 3, significant. Differences in distribution of IFs between patients ≤ 65 years old and patients > 65 years old were assessed using Pearson’s χ2 or Fisher’s exact test. Statistical significance level was set at p < 0.05.

Results

Incidental findings (n = 461) were present in 341 (52.7%) patients, while 306 (47.3%) patients did not have any extra-prostatic IF. Overall, IFs were significantly more common in patients > 65 years old (n = 225, 57.0%) compared to patients ≤ 65 years old (n = 116, 46.0%, p = 0.007). There were 139 (30.2%) IFs related to genitourinary system and 322 (69.8%) IFs not related to genitourinary system. Group 3 IFs were almost exclusively present in patients > 65 years old (2.8%, p = 0.034) and included 7 (1.1%) bladder carcinomas, 3 (0.5%) testicle tumors, 2 (0.3%) rectal cancers. Twenty-seven (4.2%) of the 647 patients underwent surgical treatment for IFs not directly related to prostate cancer.

Conclusion

IFs not related to prostate cancer may be frequently encountered on multiparametric prostate MRI, and they are significantly more common in patients > 65 years old.

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References

  1. Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA Cancer J Clin 69:7–34. https://doi.org/10.3322/caac.21551

    Article  PubMed  Google Scholar 

  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403. https://doi.org/10.1016/j.ejca.2012.12.027

    Article  CAS  PubMed  Google Scholar 

  3. Arnold M, Karim-Kos HE, Coebergh JW, Byrnes G, Antilla A, Ferlay J, Renehan AG, Forman D, Soerjomataram I (2015) Recent trends in incidence of five common cancers in 26 European countries since 1988: analysis of the European Cancer Observatory. Eur J Cancer 51:1164–1187. https://doi.org/10.1016/j.ejca.2013.09.002

    Article  PubMed  Google Scholar 

  4. Kelly SP, Anderson WF, Rosenberg PS, Cook MB (2018) Past, current, and future incidence rates and burden of metastatic prostate cancer in the United States. Eur Urol Focus 4:121–127. https://doi.org/10.1016/j.euf.2017.10.014

    Article  PubMed  Google Scholar 

  5. Prostate Cancer: Statistics. https://www.cancer.net/cancer-types/prostate-cancer/statistics. Accessed on 05 August 2019

  6. El-Shater Bosaily A, Parker C, Brown LC, Gabe R, Hindley RG, Kaplan R, Emberton M, Ahmed HU, PROMIS Group (2015) PROMIS–Prostate MR imaging study: a paired validating cohort study evaluating the role of multi-parametric MRI in men with clinical suspicion of prostate cancer. Contemp Clin Trials 42:26–40. https://doi.org/10.1016/j.cct.2015.02.008

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Nix JW, Turkbey B, Hoang A, Volkin D, Yerram N, Chua C, Linehan WM, Wood B, Choyke P, Pinto PA (2012) Very distal apical prostate tumours: identification on multiparametric MRI at 3 Tesla. BJU Int 110:E694–E700. https://doi.org/10.1111/j.1464-410X.2012.11503.x

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hoeks CM, Barentsz JO, Hambrock T, Yakar D, Somford DM, Heijmink SW, Scheenen TW, Vos PC, Huisman H, van Oort IM, Witjes JA, Heerschap A, Fütterer JJ (2011) Prostate cancer: multiparametric MR imaging for detection, localization, and staging. Radiology 26:46–66. https://doi.org/10.1148/radiol.11091822

    Article  Google Scholar 

  9. Sherrer RL, Lai WS, Thomas JV, Nix JW, Rais-Bahrami S (2018) Incidental findings on multiparametric MRI performed for evaluation of prostate cancer. Abdom Radiol (NY) 43:696–701. https://doi.org/10.1007/s00261-017-1237-x

    Article  Google Scholar 

  10. Rayn KN, Hale GR, Bloom JB, Gold SA, Carvalho FLF, Mehralivand S, Czarniecki M, Wood BJ, Merino MJ, Choyke P, Türkbey B, Pinto PA, Agarwal PK (2018) Incidental bladder cancers found on multiparametric MRI of the prostate gland: a single center experience. Diagn Interv Radiol 24:316–320. https://doi.org/10.5152/dir.2018.18102

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sardari A, Thomas JV, Nix JW, Pietryga JA, Sanyal R, Gordetsky JB, Rais-Bahrami S (2015) Incidental bladder cancer detected on multiparametric magnetic resonance imaging of the prostate gland. Case Rep Urol 2015:503154. https://doi.org/10.1155/2015/503154

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ho AA, Khara SS, Ferguson DJ, Mohammed MF, Chang SD, Harris AC (2019) A PSA for radiologists: pictorial review of incidentalomas on prostate magnetic resonance imaging. Can Assoc Radiol J 70:134–146. https://doi.org/10.1016/j.carj.2018.09.005

    Article  PubMed  Google Scholar 

  13. Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, Tempany CM, Choyke PL, Cornud F, Margolis DJ, Thoeny HC, Verma S, Barentsz J, Weinreb JC (2019) Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2. Eur Urol. https://doi.org/10.1016/j.eururo.2019.02.033

    Article  PubMed  Google Scholar 

  14. American College of Radiology. Incidental findings. https://www.acr.org/Clinical-Resources/Incidental-Findings. Accessed date on 05 August 2019

  15. Sankineni S, Brown AM, Fascelli M, Law YM, Pinto PA, Choyke PL, Turkbey B (2015) Lymph node staging in prostate cancer. Curr Urol Rep 16:30. https://doi.org/10.1007/s11934-015-0505-y

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cieszanowski A, Maj E, Kulisiewicz P, Grudzinski IP, Jakoniuk-Glodala K, Chlipala-Nitek I, Kaczynski B, Rowinski O (2014) Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects. PLoS ONE 26:e107840. https://doi.org/10.1371/journal.pone.0107840

    Article  CAS  Google Scholar 

  17. Galia M, Albano D, Narese D, Patti C, Chianca V, Di Pietto F, Mulè A, Grassedonio E, La Grutta L, Lagalla R, Midiri M (2016) Whole-body MRI in patients with lymphoma: collateral findings. Radiol Med 121:793–800. https://doi.org/10.1007/s11547-016-0658-x

    Article  PubMed  Google Scholar 

  18. American College of Radiology website (2019) Prostate imaging reporting & data system (PI-RADS). https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/PI-RADS. Accessed 05 August 2019

  19. Elmi A, Tabatabaei S, Talab SS, Hedgire SS, Cao K, Harisinghani M (2012) Incidental findings at initial imaging workup of patients with prostate cancer: clinical significance and outcomes. AJR Am J Roentgenol 199:1305–1311. https://doi.org/10.2214/AJR.11.8417

    Article  PubMed  Google Scholar 

  20. Sturludóttir M, Martling A, Carlsson S, Blomqvist L (2015) Synchronous rectal and prostate cancer–the impact of MRI on incidence and imaging findings. Eur J Radiol 84:563–567. https://doi.org/10.1016/j.ejrad.2014.12.030

    Article  PubMed  Google Scholar 

  21. Woo S, Suh CH, Kim SY, Cho JY, Kim SH (2018) The diagnostic performance of mri for detection of lymph node metastasis in bladder and prostate cancer: an updated systematic review and diagnostic meta-analysis. AJR Am J Roentgenol 210:W95–W109. https://doi.org/10.2214/AJR.17.18481

    Article  PubMed  Google Scholar 

  22. McEvoy SH, Lavelle LP, Purcell YM, Quinlan DM, Skehan SJ, Collins CD, McMahon CJ (2015) Should abdominal sequences be included in prostate cancer MR staging studies? Eur J Radiol 84:1019–1022. https://doi.org/10.1016/j.ejrad.2015.02.023

    Article  CAS  PubMed  Google Scholar 

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy

    Giuseppe Cutaia, Gaetano Tosto, Roberto Cannella, Alberto Bruno, Claudio Leto, Leonardo Salvaggio, Francesco Paolo Lombardo, Dario Giambelluca, Massimo Midiri & Giuseppe Salvaggio

  2. Department of Medical Oncology, DICHIRONS, University of Palermo, Palermo, Italy

    Sofia Cutaia

  3. Unità operativa di Urologia, Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, University of Palermo, Palermo, Italy

    Nino Dispensa

Authors
  1. Giuseppe Cutaia
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  2. Gaetano Tosto
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  3. Roberto Cannella
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  4. Alberto Bruno
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  5. Claudio Leto
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  7. Sofia Cutaia
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  10. Dario Giambelluca
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Correspondence to Roberto Cannella.

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Cutaia, G., Tosto, G., Cannella, R. et al. Prevalence and clinical significance of incidental findings on multiparametric prostate MRI. Radiol med 125, 204–213 (2020). https://doi.org/10.1007/s11547-019-01106-9

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  • DOI: https://doi.org/10.1007/s11547-019-01106-9

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