2193 BONE ABNORMAL SIGNAL INCIDENTALLY FOUND IN PRE-BIOPSY DIFFUSION-WEIGHTED MRI FOR SUSPICIOUS OF PROSTATE CANCER: DOES THE SIGNAL REFLECT METASTASIS FROM PROSTATE CANCER?

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You have accessJournal of UrologyImaging/Radiology: Uroradiology (II)1 Apr 20132193 BONE ABNORMAL SIGNAL INCIDENTALLY FOUND IN PRE-BIOPSY DIFFUSION-WEIGHTED MRI FOR SUSPICIOUS OF PROSTATE CANCER: DOES THE SIGNAL REFLECT METASTASIS FROM PROSTATE CANCER? Yuki Yachida, Hideki Takeshita, Soichiro Yoshida, Chigusa Sawamura, Hiroshi Tanaka, Shiro Sato, Minato Yokoyama, Junichiro ishioka, Yoh Matsuoka, Kazutaka Saito, Fumitaka Koga, Yasuhisa Fujii, and Kazunori Kihara Yuki YachidaYuki Yachida Tokyo, Japan More articles by this author , Hideki TakeshitaHideki Takeshita Tokyo, Japan More articles by this author , Soichiro YoshidaSoichiro Yoshida Tokyo, Japan More articles by this author , Chigusa SawamuraChigusa Sawamura Tokyo, Japan More articles by this author , Hiroshi TanakaHiroshi Tanaka Tokyo, Japan More articles by this author , Shiro SatoShiro Sato Tokyo, Japan More articles by this author , Minato YokoyamaMinato Yokoyama Tokyo, Japan More articles by this author , Junichiro ishiokaJunichiro ishioka Tokyo, Japan More articles by this author , Yoh MatsuokaYoh Matsuoka Tokyo, Japan More articles by this author , Kazutaka SaitoKazutaka Saito Tokyo, Japan More articles by this author , Fumitaka KogaFumitaka Koga Tokyo, Japan More articles by this author , Yasuhisa FujiiYasuhisa Fujii Tokyo, Japan More articles by this author , and Kazunori KiharaKazunori Kihara Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2102AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Diffusion-weighted MRI (DWI) is a functional imaging technique widely used to detect prostate cancer, and the advantage of DWI over bone scintigraphy in detecting bone metastases has been reported. However, it has not been clarified the clinical significance of incidentally found high intensity lesions in the pelvic and femoral bone on pre-biopsy pelvic DWI for suspicious of prostate cancer. We investigate the clinical features of these bone lesions showing DWI positive findings. METHODS Between March 2011 and August 2012, 754 consecutive patients suspected of having prostate cancer underwent multi-sequence pelvic MRI including T1- & T2-weighted imaging (T1W & T2W) and DWI using a 1.5-T MR imager (Intera Achieva; Philips) with a 32-channel SENSE body coil. DWI with single-shot spin-echo planar imaging sequence was obtained using 3 different b-value of 0, 1000 and 2000 s/mm2 with SPAIR fat suppression. The observers pointed out 48 bone abnormal DWI lesions (b-value of 1000 s/mm2) in 26 patients (median age, 70 [range 53 - 85]; median PSA level, 11.1 ng/ml [range 0.2 - 264.7]). The findings of each imaging sequence in addition to the ADC value of those lesions were compared with the clinical diagnosis made by one radiologist and one orthopedic oncologist. RESULTS Of the 48 DWI positive bone lesions, 21 (44%) were metastatic prostate cancer. The remaining 27 (56%) were diagnosed as hematopoietic bone marrow in 18, enchondroma in 3, ganglion in 1, osteoma in 1, fibrous dysplasia in 1, bone fracture in 1, bone infarction in 1 and unclear in 1. All enchondroma, ganglion, osteoma, and fibrous dysplasia showed T1W low & T2W high signal intensity, while others including prostate cancer metastases showed T1W low & T2W low signal intensity. Of these 42 lesions with T1W low & T2W low, the ADC values of metastatic prostate cancer were significantly higher than those of other benign lesions (median, 0.42 × 10-3 mm2/s vs 0.27 × 10-3 mm2/s; P = 0.0002). CONCLUSIONS DWI positive lesion represents coexisting various types of bone lesions including metastasis in patients with a suspicion of prostate cancer. T2W finding and ADC value help to discriminate metastatic cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e899 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yuki Yachida Tokyo, Japan More articles by this author Hideki Takeshita Tokyo, Japan More articles by this author Soichiro Yoshida Tokyo, Japan More articles by this author Chigusa Sawamura Tokyo, Japan More articles by this author Hiroshi Tanaka Tokyo, Japan More articles by this author Shiro Sato Tokyo, Japan More articles by this author Minato Yokoyama Tokyo, Japan More articles by this author Junichiro ishioka Tokyo, Japan More articles by this author Yoh Matsuoka Tokyo, Japan More articles by this author Kazutaka Saito Tokyo, Japan More articles by this author Fumitaka Koga Tokyo, Japan More articles by this author Yasuhisa Fujii Tokyo, Japan More articles by this author Kazunori Kihara Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...