학술논문
Detection of the Highest-Grade Lesion in Multifocal Discordant Prostate Cancer by Multiparametric Magnetic Resonance Imaging.
Document Type
Academic Journal
Author
Matsumoto K; Department of Urology, Keio University School of Medicine, Tokyo, Japan. Electronic address: kazz_matsumoto@yahoo.co.jp.; Akita H; Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.; Hashiguchi A; Department of Pathology, Keio University School of Medicine, Tokyo, Japan.; Takeda T; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Kosaka T; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Fukumoto K; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Yasumizu Y; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Tanaka N; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Morita S; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Mizuno R; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Asanuma H; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Oya M; Department of Urology, Keio University School of Medicine, Tokyo, Japan.; Jinzaki M; Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 101260955 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-0682 (Electronic) Linking ISSN: 15587673 NLM ISO Abbreviation: Clin Genitourin Cancer Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Prostate cancer generally occurs multifocally. The lesions of the largest size and highest-grade are often concordant, and defined as an index tumor. However, these factors sometimes do not coincide within one lesion. In such discordant cases, not the largest size lesion but the highest-grade lesion is known to determine the prognosis. We focused on the multiparametric magnetic resonance imaging (mpMRI) detectability of the highest-grade tumors in discordant cases.
Materials and Methods: We investigated the detectability of the highest-grade tumor using preoperative mpMRI in 50 discordant patients who underwent radical prostatectomy. The radiologist was informed of the tumor location on the pathological tumor map, and mpMRI interpretation for each tumor was performed.
Results: Prostate Imaging-Reporting and Data System (PI-RADS) scores of 1, 2, 3, 4, and 5 on preoperative mpMRI were assigned to 13, 1, 9, 16, and 11 of the largest tumors, respectively. On the other hand, scores of 1, 2, 3, 4, and 5 were assigned to 23, 0, 7, 19, and 1 of the highest-grade tumors, respectively. The difference between them was statistically significant (p=0.007). We also found that the largest anterior tumor frequently hid the ipsilateral posterior highest-grade tumor; the detection rate of the highest-grade tumor in this pattern was 42.1% (8 of 19 cases) CONCLUSION: We found that mpMRI detectability of the highest-grade tumor in discordant cases was inferior to that of the largest tumor with low malignant potential. Our results suggest that the risk of high-grade tumors which determine patient prognosis being overlooked.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Materials and Methods: We investigated the detectability of the highest-grade tumor using preoperative mpMRI in 50 discordant patients who underwent radical prostatectomy. The radiologist was informed of the tumor location on the pathological tumor map, and mpMRI interpretation for each tumor was performed.
Results: Prostate Imaging-Reporting and Data System (PI-RADS) scores of 1, 2, 3, 4, and 5 on preoperative mpMRI were assigned to 13, 1, 9, 16, and 11 of the largest tumors, respectively. On the other hand, scores of 1, 2, 3, 4, and 5 were assigned to 23, 0, 7, 19, and 1 of the highest-grade tumors, respectively. The difference between them was statistically significant (p=0.007). We also found that the largest anterior tumor frequently hid the ipsilateral posterior highest-grade tumor; the detection rate of the highest-grade tumor in this pattern was 42.1% (8 of 19 cases) CONCLUSION: We found that mpMRI detectability of the highest-grade tumor in discordant cases was inferior to that of the largest tumor with low malignant potential. Our results suggest that the risk of high-grade tumors which determine patient prognosis being overlooked.
(Copyright © 2024 Elsevier Inc. All rights reserved.)