Interpreting Prostate Multiparametric MRI: Beyond Adenocarcinoma - Anatomical Variations, Mimickers, and...

Area of Science:

• Radiology and Imaging Science
• Urologic Oncology
• Medical Diagnostics

Background:

• Prostate magnetic resonance imaging (MRI) is crucial for prostate cancer diagnosis.
• Benign prostate conditions can present with imaging features similar to malignancy, complicating diagnosis.
• Accurate differentiation between benign and malignant prostate lesions on MRI is clinically significant.

Purpose of the Study:

• To review the MRI phenotypes of common and rare benign prostate conditions.
• To identify non-cancerous entities that may be misdiagnosed as prostate cancer on MRI.
• To discuss factors influencing MRI diagnostic accuracy, including image quality and AI applications.

Main Methods:

• Comprehensive literature review of studies on benign prostate conditions and their MRI appearances.
• Synthesis of current knowledge regarding radiological features of non-neoplastic prostate mimics.
• Analysis of the impact of MRI quality and emerging AI tools on diagnostic performance.

Main Results:

• Benign prostate conditions, including anatomical variants, other neoplasms, inflammatory processes, and post-intervention changes, exhibit diverse MRI phenotypes.
• These benign entities can radiologically resemble prostate cancer, necessitating careful interpretation.
• High-quality MRI and advanced interpretation techniques, such as artificial intelligence, are vital for accurate diagnosis.

Conclusions:

• Understanding the MRI characteristics of benign prostate mimics is essential for accurate prostate cancer diagnosis.
• Attention to MRI quality and the integration of AI tools can significantly improve diagnostic confidence and reduce misdiagnosis.
• This review provides a framework for differentiating benign from malignant prostate findings on MRI.