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Pitfalls in Interpreting mp-MRI of the Prostate: A Pictorial Review with Pathologic Correlation
V Panebianco1, F Barchetti2, J Barentsz3
1Department of Radiological Sciences, Oncology & Pathology- Sapienza Unviersity of Rome, V.le Regina Elena, 324 00161, Roma, Italy. valeria.panebianco@gmail.com.
Objectives:
The purpose of this pictorial review is to present a wide spectrum of prostate multiparametric MRI (mp-MRI) pitfalls that may occur in clinical practice, with radiological and pathological correlation.
Methods:
All examinations were performed according to ESUR Guidelines protocols.
Results And Conclusion:
mp-MRI imaging of the prostate often leads to interpreting doubts and misdiagnosis due to the many interpretative pitfalls that a tissue, whether healthy or treated, may cause. These "false-positive" findings may occur in each stage of the disease history, from the primary diagnosis and staging, to the post-treatment stage, and whether they are caused by the tissue itself or are iatrogenic, their recognition is critical for proper treatment and management. Knowledge of these known pitfalls and their interpretation in the anatomical-radiological context can help radiologists avoid misdiagnosis and consequently mistreatment.
Main Messages:
• Some physiological changes in the peripheral and central zone may simulate prostate cancer. • Technical errors, such as mispositioned endorectal coils, can affect the mp-MRI interpretation. • Physiological changes post-treatment can simulate recurrence.
Insights
Prostate multiparametric MRI (mp-MRI) can lead to misdiagnosis due to various pitfalls. Recognizing these false-positive findings, whether from tissue changes or iatrogenic causes, is crucial for accurate prostate cancer management.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate multiparametric MRI (mp-MRI) is essential for diagnosing and staging prostate cancer.
- Interpretative challenges in mp-MRI can lead to diagnostic uncertainty and misdiagnosis.
Purpose of the Study:
- To present a comprehensive review of prostate mp-MRI pitfalls.
- To correlate radiological findings with pathological data for improved understanding.
Main Methods:
- Review of prostate mp-MRI examinations performed according to ESUR Guidelines.
- Analysis of cases demonstrating potential pitfalls and false-positive findings.
Main Results:
- Physiological changes in prostate zones can mimic cancer.
- Technical errors, such as incorrect coil positioning, can impact interpretation.
- Post-treatment changes may simulate recurrent prostate cancer.
Conclusions:
- Prostate mp-MRI interpretation is prone to pitfalls causing misdiagnosis.
- Recognition of false-positive findings, from physiological or iatrogenic causes, is critical.
- Understanding these pitfalls aids radiologists in avoiding misdiagnosis and ensuring appropriate patient management.
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