MP40-07 3T MULTIPARAMETRIC MRI BASED DETECTION OF PROSTATE CANCER: FEATURES OF DETECTED AND MISSED TUMORS BASE ON PIRADS V2 IN 429 PATIENTS- USING WHOLE MOUNT HISTOPATHOLOGY REFERENCE

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III1 Apr 2018MP40-07 3T MULTIPARAMETRIC MRI BASED DETECTION OF PROSTATE CANCER: FEATURES OF DETECTED AND MISSED TUMORS BASE ON PIRADS V2 IN 429 PATIENTS- USING WHOLE MOUNT HISTOPATHOLOGY REFERENCE Amirhossein Mohammadian Bajgiran, Sohrab Afshari Mirak, Ely Felker, Preeti Ahuja, Cleo Maehara, William Hsu, David Lu, Robert Reiter, Anthony Sisk, and Steve Raman Amirhossein Mohammadian BajgiranAmirhossein Mohammadian Bajgiran More articles by this author , Sohrab Afshari MirakSohrab Afshari Mirak More articles by this author , Ely FelkerEly Felker More articles by this author , Preeti AhujaPreeti Ahuja More articles by this author , Cleo MaeharaCleo Maehara More articles by this author , William HsuWilliam Hsu More articles by this author , David LuDavid Lu More articles by this author , Robert ReiterRobert Reiter More articles by this author , Anthony SiskAnthony Sisk More articles by this author , and Steve RamanSteve Raman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1274AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although some studies have already been published in order to the diagnosis performance of Prostate Imaging Reporting and Data System (PI-RADS) Version 2 in the detection of PCa, still there is some discrepancy between their results. The purpose of this study was to determine the performance of 3T multiparametric MRI in prostate cancer, using PIRADS v2, and explain the characteristics of detected and missed tumors. METHODS A retrospective study was performed of 429 consecutive men who underwent mp-MRI before radical prostatectomy at a single referral academic center between Dec 2009 and Jun 2016. Clinical, mp-MRI (i.e., T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging) and pathologic features were obtained. A structural report system, based on PI-RADS v2, was used for reporting qualitative and quantitative (DWI and DCE) features of each MRI detected lesion. MRI detected lesions were matched with previously finalized whole mount thin section histopathology (WMHP) in a joint session by a genitourinary (GU) radiologist and GU pathologist. MRI lesion detection rate was calculated. RESULTS Of 874 PCa lesions in 429 patients on WMHP, 3T MRI detected 443(49.3%) overall and 334 of 429 (77.9%) index lesions based on PIRADS v2. The 3T MRI detection rate was significantly higher in larger (70.4%, pathology size > 1cm) and higher grade (71.8%, Gleason score =7) PCa (p-value < 0.001). Of 441 missed lesions 308 (76.6%) had Gleason score = 6 and 287 (81.3%) were = 1 cm. Detection rate was highest in the mid gland 55.1% compared to the base and apex (p<0.001). The detection rate was not significantly different in the peripheral and transitional zones (50.8% vs 46% p =0.217). Sensitivity for index lesions detection was significantly higher in solitary (87.5%) vs multifocal tumors (74.7%) (p-value = 0.003). Prostate volume was significantly less in detected tumors (39.4cc), compared to missed tumors (47.1cc), p-value <0.001. PSA density was significantly higher in detected index lesions compared to the missed lesions. CONCLUSIONS In this large 3T Prostate MRI cohort with WMHP, tumor detection rate based on PIRADS v2 increased by PCa size, grade and stage was significantly higher for index lesions. Index and overall tumor detection rate was similar in the TZ and PZ and was higher with higher PSA density, in solitary tumors and smaller prostate volumes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e522 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Amirhossein Mohammadian Bajgiran More articles by this author Sohrab Afshari Mirak More articles by this author Ely Felker More articles by this author Preeti Ahuja More articles by this author Cleo Maehara More articles by this author William Hsu More articles by this author David Lu More articles by this author Robert Reiter More articles by this author Anthony Sisk More articles by this author Steve Raman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...