BRIDGING GAP BETWEEN PRE AND POSTOPERATIVE PROSTATE BIOPSIES: PI RADS CORRELATION WITH FINAL HISTOPATHOLOGICAL DATA.

Georgian Med News

1Iv. Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia; 2Acad. F. Todua Medical Center, Magnetic Resonance Imaging Department, Tbilisi, Georgia.

Published: June 2023

We aim to define strength of correlation between Prostate Imaging Reporting and Data System (PI RADS) scores of prostate cancer and final histopathological data-postoperative Gleason scores (Gs); apparent diffusion coefficient (ADC) and Gs; to define mean ADC values for each Gleason grade as well. To determine compliance of MRI data in preoperative prostate cancer grading with gold standard-morphological data. 203 consecutive patients suspected for prostate cancer (Pc) on multiparametric MRI, who underwent subsequent preoperative TRUS or MRI/Ultrasound fusion guided biopsies were included to this study prospectively. 50 patients were excluded due to preoperative negative prostate biopsies, leaving 153 treatment-naïve patients, with positive preoperative biopsies. Multiparametric MRI (mpMRI)s were interpreted utilizing PI RADS V.2.1; this data was correlated with histopathological findings. Concordance of preoperative and postoperative Gleason scores was evaluated as well. Relationship of PI RADS and Gleason scores was defined by Pearson's correlation. It revealed a highly positive correlation of PI RADS sum scores and Gleason scores (r=0.646 and p=0.000.) A high negative correlation was seen between apparent diffusion coefficient (ADC) and Gleason scores (r=-0.849 and p=0.000). Mean ADC values were calculated for each Gleason group. 18 patients out of 153 showed Gs upgrade from TRUS biopsies to prostatectomy specimens. PI RADS sum scores and Gleason grades demonstrated significantly high correlation for our patients. With apparent diffusion coefficient calculation PI RADS preoperatively can predict Gs noninvasively and this makes mpMRI valuable tool in preoperative prostate cancer grading, as it gives reliable data among pre and postoperative pathological reports providing an optimal treatment strategy.

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