Department of Urology, Gifu University Graduate School of Medicine, Gifu 5011194, Japan.
Department of Urology, Gifu Municipal Hospital, Gifu 5008513, Japan.
Curr Oncol. 2024 May 16;31(5):2846-2855. doi: 10.3390/curroncol31050216.
Accurate diagnosis of the localization of prostate cancer (PCa) on magnetic resonance imaging (MRI) remains a challenge. We aimed to assess discrepancy between the location of PCa pathologically diagnosed using surgical specimens and lesions indicated as possible PCa by the Prostate Imaging Reporting and Data System on MRI. The primary endpoint was the concordance rate between the site of probable clinically significant PCa (csPCa) identified using biparametric MRI (bpMRI) and location of PCa in the surgical specimen obtained using robot-assisted total prostatectomy. Among 85 lesions identified in 30 patients; 42 (49.4%) were identified as possible PCa on MRI. The 85 PCa lesions were divided into positive and negative groups based on the bpMRI results. None of the patients had missed csPCa. Although the diagnostic accuracy of bpMRI was relatively high for PCas located in the middle of the prostate ( = 0.029), it was relatively low for PCa located at the base of the prostate, all of which were csPCas. Although current modalities can accurately diagnose PCa, the possibility that PCa is present with multiple lesions in the prostate should be considered, even if MRI does not detect PCa.
在磁共振成像(MRI)上准确诊断前列腺癌(PCa)的定位仍然具有挑战性。我们旨在评估使用手术标本病理诊断的 PCa 位置与 MRI 上前列腺影像报告和数据系统(PI-RADS)指示的可能 PCa 病变之间的差异。主要终点是使用双参数 MRI(bpMRI)识别的可能临床上显著 PCa(csPCa)的部位与使用机器人辅助全前列腺切除术获得的手术标本中 PCa 的位置之间的一致性率。在 30 名患者中确定的 85 个病变中;42 个(49.4%)在 MRI 上被确定为可能的 PCa。根据 bpMRI 结果,85 个 PCa 病变分为阳性和阴性两组。没有患者遗漏 csPCa。尽管 bpMRI 对位于前列腺中部的 PCa 的诊断准确性相对较高(=0.029),但对位于前列腺底部的 PCa 的诊断准确性相对较低,而所有这些都是 csPCa。尽管目前的方法可以准确诊断 PCa,但即使 MRI 未检测到 PCa,也应考虑前列腺内存在多个病变的可能性。