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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
The visibility of prostate cancer concerning underlying histopathological variances: A single-center multiparametric
Aydan Arslan1, Deniz Alis2, Mustafa Bilal Tuna3
1Zonguldak Maternity and Child Health Hospital, Department of Radiology, Turkey.
Purpose:
To investigate whether prostate cancer (PCa) lesions regarding histopathological composition exhibit different morphological features on multiparametric prostate MRI (mpMRI).
Methods:
We investigated men with PCa with available mpMRI and whole-mount specimens between June 2015 to December 2020.The acquisition protocol consistent with the Prostate Imaging Reporting and Data System (PI-RADS). Two observers evaluated the images following the PI-RADS v2.1. guideline before biopsy and radical prostatectomy. The discrepancies were resolved in a joint meeting. A genitourinary pathologist reviewed the whole-digitalized mount specimens, and the lesions with Gleason score of 7 and above (3 + 4 and above), and/or cancers with a maximum diameter of 6 mm and more, and/or extraprostatic extension were accepted as clinically significant PCa. The PI-RADS scores and the diameter of the clinically significant PCa on mpMRI concerning histopathological components (i.e., cribriform component, intraductal pattern, or without cribriform component or intraductal pattern) were investigated. The clinically significant PCa foci with PI-RADS score <3 was accepted as an invisible lesion on mpMRI.
Results:
In all, 58 men with a total of 112 clinically significant PCa foci, were enrolled in the study. The intraductal pattern, cribriform pattern, or none of these patterns were observed in 28/112 (25 %), 43/112 (38.05 %), and 41/112 (36.60 %) tumor foci. Six out of 28 (21.42 %), 17/43 (39.53 %), and 18/41 (42.8 %) foci with an intraductal pattern, cribriform component, or without any of them, respectively, were invisible on mpMRI (P = 0.111).
Conclusion:
Though it was not reached a statistical significance, clinically significant PCa with the cribriform component and without any intraductal or cribriform component are more likely to manifests mpMRI invisible foci than the intraductal pattern. Further multi-center studies are warranted to precisely elucidate mpMRI features of PCa regarding histopathological composition.
Insights
Prostate cancer (PCa) with cribriform or no specific patterns may be invisible on multiparametric MRI (mpMRI). Further studies are needed to clarify mpMRI features of PCa based on histopathology.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Multiparametric MRI (mpMRI) is crucial for prostate cancer (PCa) detection.
- Understanding the relationship between mpMRI findings and PCa histopathology is essential for accurate diagnosis and treatment planning.
Purpose of the Study:
- To determine if distinct histopathological compositions of PCa lesions correlate with different morphological features on mpMRI.
- To investigate the visibility of PCa foci with specific histopathological patterns on mpMRI.
Main Methods:
- Retrospective analysis of 58 men with PCa, comparing mpMRI data with whole-mount histopathology specimens.
- Lesions were evaluated using Prostate Imaging Reporting and Data System (PI-RADS) v2.1 criteria.
- Clinically significant PCa was defined by Gleason score, size, or extraprostatic extension.
Main Results:
- Of 112 clinically significant PCa foci, 25% had an intraductal pattern, 38.05% had a cribriform pattern, and 36.60% had neither.
- Foci with cribriform patterns (39.53%) and no specific patterns (42.8%) were more frequently invisible on mpMRI compared to those with intraductal patterns (21.42%).
- This difference did not reach statistical significance (P=0.111).
Conclusions:
- Clinically significant PCa with cribriform components or lacking specific intraductal/cribriform patterns may be more prone to being "invisible" on mpMRI.
- While not statistically significant in this study, these findings suggest potential differences in mpMRI detectability based on PCa histopathology.
- Multi-center studies are recommended to further elucidate the mpMRI characteristics of PCa concerning its histopathological composition.
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