Prostate cancer: correlation of MR images with tissue optical density at pathologic examination

To explain the variability in detection of prostate cancer with magnetic resonance (MR) imaging, the authors correlated preoperative MR findings in 28 patients with tissue optical density (TOD) measurements on whole-mount pathologic slides prepared from radical prostatectomy specimens. TOD was used as an indicator of the degree of tissue compactness or openness. TOD measurements from proved cancers and from pathologic regions corresponding to MR lesions (areas of low signal intensity seen at T2-weighted MR imaging) were compared with TOD measurements from adjacent, nonmalignant tissue. TOD measurements corresponding to MR lesions were higher than noncancerous tissue measurements in all cases (P less than .005). Although most of these lesions represented cancers (21 of 30), nine of 30 represented benign tissue that was composed mainly of densely packed fibromuscular stroma (30% false-positive results). Thus, signal intensity appeared to be related to TOD rather than to a specific histologic tissue type, and the finding of a peripheral zone lesion with low signal intensity did not necessarily indicate the presence of a cancer.