Skip to main content
SpringerLink
Log in

Whole mount histopathological correlation with prostate MRI in Grade I and II prostatectomy patients

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Background

Multiparametric magnetic resonance imaging (mpMRI) is increasingly used in detection and surveillance of prostate cancer. However, the co-localization of lower grade lesions between mpMRI and histopathologic specimen has not been well established.

Objective

We aim to determine the factors on final histopathological exam that correlate to tumor visibility for Grade I and II disease on mpMRI.

Methods

Fifty-five patients who underwent radical prostatectomy from July 2014 to June 2016 were analyzed for the study. Of the sample of 55 patients, 18 were found to have Gleason score (GS) of 3 + 3 or 3 + 4 disease, and then were re-reviewed and annotated by a pathologist. Lesion diameter, area, and distance from the prostate capsule were measured. The annotated lesions were co-localized to the MRI report.

Results

Of the 184 lesions identified on the whole mount histopathologic slides, 106 (57.6%), 62 (33.7%), 14 (7.6%), and 2 (1.1%) of the lesions had a GS of 3 + 3, 3 + 4, 4 + 3, and 4 + 4, respectively. On analysis, 27.3% (24/88) of GS 6 (< 1.5 cm in size), and 88.9% (16/18) of GS 6 (> 1.5 cm in size) were identified (p < 0.001). Additionally, when assessing lesion proximity to the prostatic capsule, 46.1% (41/89) of lesions closer (≤ 0.05 cm), and 30.5% (29/95) of lesions further (> 0.05 cm) from the capsule were visualized.

Conclusion

Lesion diameter, area, and capsule proximity correlated with MRI visibility. Further studies are encouraged to validate the findings of our study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Le JD, Tan N, Shkolyar E et al (2015) Multifocality and prostate cancer detection by multiparametric magnetic resonance imaging: correlation with whole-mount histopathology. Eur Urol 67:569–576

    Article  PubMed  Google Scholar 

  2. Russo F, Regge D, Armando E et al (2016) Detection of prostate cancer index lesions with multiparametric magnetic resonance imaging (mp-MRI) using whole-mount histological sections as the reference standard. BJU Int 118:84–94

    Article  PubMed  Google Scholar 

  3. Bratan F, Niaf E, Melodelima C et al (2013) Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 23:2019–2029

    Article  PubMed  Google Scholar 

  4. Becker AS, Cornelius A, Reiner CS et al (2017) Direct comparison of PI-RADS version 2 and version 1 regarding interreader agreement and diagnostic accuracy for the detection of clinically significant prostate cancer. Eur J Radiol 94:58–63

    Article  PubMed  Google Scholar 

  5. Barentsz JO, Weinreb JC, Verma S et al (2016) Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol 69:41–49

    Article  PubMed  Google Scholar 

  6. Weinreb JC, Barentsz JO, Choyke PL et al (2016) PI-RADS prostate imaging—reporting and data system: 2015, Version 2. Eur Urol 69:16–40

    Article  PubMed  Google Scholar 

  7. Liu W, Laitinen S, Khan S et al (2009) Copy number analysis indicates monoclonal origin of lethal metastatic prostate cancer. Nat Med 15:559–565

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Turkbey B, Brown AM, Sankineni S et al (2016) Multiparametric prostate magnetic resonance imaging in the evaluation of prostate cancer. CA Cancer J Clin 66:326–336

    Article  PubMed  Google Scholar 

  9. Baco E, Ukimura O, Rud E et al (2015) Magnetic resonance imaging–transectal ultrasound image-fusion biopsies accurately characterize the index tumor: correlation with step-sectioned radical prostatectomy specimens in 135 patients. Eur Urol 67:787–794

    Article  PubMed  Google Scholar 

  10. Rud E, Klotz D, Rennesund K et al: Detection of the index tumour and tumour volume in prostate cancer using T2-weighted and diffusion-weighted magnetic resonance imaging (MRI) alone. BJU Int 114: E32–E42

  11. Delongchamps NB, Lefèvre A, Bouazza N et al (2015) Detection of significant prostate cancer with magnetic resonance targeted biopsies—should transrectal ultrasound-magnetic resonance imaging fusion guided biopsies alone be a standard of care? J Urol 193:1198–1204

    Article  PubMed  Google Scholar 

  12. Rosenkrantz AB, Verma S, Turkbey B (2015) Prostate cancer: top places where tumors hide on multiparametric MRI. Am J Roentgenol 204:W449–W456

    Article  Google Scholar 

  13. Rosenkrantz AB, Taneja SS (2015) Prostate MRI can reduce overdiagnosis and overtreatment of prostate cancer. Acad Radiol 22:1000–1006

    Article  PubMed  Google Scholar 

  14. Panebianco V, Barchetti F, Barentsz J et al (2015) Pitfalls in interpreting mp-MRI of the prostate: a pictorial review with pathologic correlation. Insights Imaging 6:611–630

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. de Gorski A, Rouprêt M, Peyronnet B et al (2015) Accuracy of magnetic resonance imaging/ultrasound fusion targeted biopsies to diagnose clinically significant prostate cancer in enlarged compared to smaller prostates. J Urol 194:669–673

    Article  PubMed  Google Scholar 

  16. Giannarini G, Crestani A, Rossanese M et al (2017) Multiparametric magnetic resonance imaging targeted biopsy for early detection of prostate cancer: All That Glitters Is Not Gold! Eur Urol 71:904–906

    Article  PubMed  Google Scholar 

  17. Walton Diaz A, Hoang AN, Turkbey B et al (2013) Can magnetic resonance-ultrasound fusion biopsy improve cancer detection in enlarged prostates? J Urol 190:2020–2025

    Article  PubMed  Google Scholar 

  18. Zhu X, Albertsen PC, Andriole GL et al (2012) Risk-based prostate cancer screening. Eur Urol 61:652–661

    Article  PubMed  Google Scholar 

  19. Briganti A, Chun FK-H, Suardi N et al (2007) Prostate volume and adverse prostate cancer features: fact not artifact. Eur J Cancer 43:2669–2677

    Article  CAS  PubMed  Google Scholar 

  20. Freedland SJ, Isaacs WB, Platz EA et al (2005) Prostate size and risk of high-grade, advanced prostate cancer and biochemical progression after radical prostatectomy: a search database study. J Clin Oncol 23:7546–7554

    Article  PubMed  Google Scholar 

  21. Chen ME, Troncoso P, Johnston D et al (1999) Prostate cancer detection: relationship to prostate size. Urology 53:764–768

    Article  CAS  PubMed  Google Scholar 

  22. Rosenkrantz AB, Lim RP, Haghighi M et al (2013) Comparison of interreader reproducibility of the prostate imaging reporting and data system and Likert scales for evaluation of multiparametric prostate MRI. Am J Roentgenol 201:W612–W618

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urologic Oncology, Urology Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Michael Wang, Christina Buzzy, Laura Bukavina, Amr Mahran, Kirtishri Mishra & Lee Ponsky

  2. Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Nafiseh Janaki & Gregory MacLennan

  3. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Michael Wang, Christina Buzzy, Amr Mahran & Lee Ponsky

Authors
  1. Michael Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nafiseh Janaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina Buzzy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Bukavina
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amr Mahran
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kirtishri Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gregory MacLennan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lee Ponsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lee Ponsky.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (JPG 95 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, M., Janaki, N., Buzzy, C. et al. Whole mount histopathological correlation with prostate MRI in Grade I and II prostatectomy patients. Int Urol Nephrol 51, 425–434 (2019). https://doi.org/10.1007/s11255-019-02083-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-019-02083-8

Keywords

Search

Navigation