TY - JOUR
T1 - Multiparametric magnetic resonance imaging identifies significant apical prostate cancers
AU - Kenigsberg, Alexander P.
AU - Tamada, Tsutomu
AU - Rosenkrantz, Andrew B.
AU - Llukani, Elton
AU - Deng, Fang Ming
AU - Melamed, Jonathan
AU - Zhou, Ming
AU - Lepor, Herbert
N1 - Publisher Copyright:
© 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd
PY - 2018/2
Y1 - 2018/2
N2 - Objective: To determine if multiparametric (mp) magnetic resonance imaging (MRI) can identify significant apical disease, thereby informing decisions regarding preservation of the membranous urethra. Materials and Methods: Men undergoing radical prostatectomy (RP) between January 2012 and June 2016, who underwent a 12-core transrectal ultrasonography-guided systematic biopsy (SB), preoperative 3-Tesla MRI, and sectioning of the prostate specimen with tumour foci mapping, were extracted from a single surgeon's prospective longitudinal outcomes database. Apical SB and mpMRI lesion results were compared with regard to their ability to predict aggressive tumours in the prostatic apex (PA), defined as prostate cancer grade group >1. Results: Of the 100 men who met the eligibility criteria, 43 (43%) exhibited aggressive prostate cancer in the distal 5 mm of the apex. A Likert score >2 in the apical one-third of the prostate was found to be more reliable than any cancer found on apical SB at detecting aggressive cancer in the apex. On multivariate regression analysis, which included Likert score in the apex, age, prostate-specific antigen (PSA) level, prostate size and presence of any cancer on apical biopsy, only Likert score (P = 0.005) and PSA level (P = 0.025) were significant and independent predictors of aggressive cancer in the distal apex. Conclusion: The results of the study showed that MRI was superior to SB at identifying aggressive prostate cancer within the distal PA and may be useful for planning the extent of apical preservation during RP.
AB - Objective: To determine if multiparametric (mp) magnetic resonance imaging (MRI) can identify significant apical disease, thereby informing decisions regarding preservation of the membranous urethra. Materials and Methods: Men undergoing radical prostatectomy (RP) between January 2012 and June 2016, who underwent a 12-core transrectal ultrasonography-guided systematic biopsy (SB), preoperative 3-Tesla MRI, and sectioning of the prostate specimen with tumour foci mapping, were extracted from a single surgeon's prospective longitudinal outcomes database. Apical SB and mpMRI lesion results were compared with regard to their ability to predict aggressive tumours in the prostatic apex (PA), defined as prostate cancer grade group >1. Results: Of the 100 men who met the eligibility criteria, 43 (43%) exhibited aggressive prostate cancer in the distal 5 mm of the apex. A Likert score >2 in the apical one-third of the prostate was found to be more reliable than any cancer found on apical SB at detecting aggressive cancer in the apex. On multivariate regression analysis, which included Likert score in the apex, age, prostate-specific antigen (PSA) level, prostate size and presence of any cancer on apical biopsy, only Likert score (P = 0.005) and PSA level (P = 0.025) were significant and independent predictors of aggressive cancer in the distal apex. Conclusion: The results of the study showed that MRI was superior to SB at identifying aggressive prostate cancer within the distal PA and may be useful for planning the extent of apical preservation during RP.
KW - #ProstateCancer
KW - biopsy
KW - diagnostic imaging
KW - magnetic resonance imaging
KW - prostatic neoplasms
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U2 - 10.1111/bju.13987
DO - 10.1111/bju.13987
M3 - Article
C2 - 28805295
AN - SCOPUS:85028834840
VL - 121
SP - 239
EP - 243
JO - British Journal of Urology
JF - British Journal of Urology
SN - 1464-4096
IS - 2
ER -