Prostate heterogeneity correlates with clinical features on multiparametric MRI

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate heterogeneity on multi-parametric MRI (mpMRI) can complicate lesion detection.
• Systematic biopsy (SB) may play a role in interpreting heterogeneous prostate MRI findings.

Purpose of the Study:

• To investigate the correlation between prostate heterogeneity and clinical risk factors.
• To determine if prostate heterogeneity associates with higher-grade tumors found via SB compared to MRI-directed target biopsy (MDTB).
• To establish a rationale for utilizing combined biopsy strategies.

Main Methods:

• Retrospective analysis of 93 patients undergoing mpMRI, SB, and MDTB.
• Regions of interest defined on T2WI, ADC, and DCE images to quantify heterogeneity (standard deviation) in transition zone (TZ) and peripheral zone (PZ).
• Spearman correlation and univariate logistic regression used to analyze associations between clinical, imaging variables, and biopsy outcomes.

Main Results:

• Age correlated with TZ ADC heterogeneity (rho=0.34, p=0.013).
• PZ T2WI heterogeneity correlated with PZ ADC heterogeneity (rho=0.48, p<0.001).
• TZ ADC heterogeneity showed a preliminary association with SB > MDTB (p=0.032) before multiple comparison correction.

Conclusions:

• TZ ADC heterogeneity may indicate prostatic hyperplasia or cancer and correlates with age.
• PZ heterogeneity may reflect prostatitis and correlates with TZ hyperplasia/inflammation.
• Further research is warranted to clarify the significance of ADC heterogeneity in prostate cancer detection and biopsy guidance.