Introduction: Cancer rates for Prostate Imaging-Reporting and Data System (PI-RADS) 3 lesions are low. We aimed to determine the clinical and magnetic resonance imaging (MRI) parameters that can provide risk stratification for PI-RADS 3 transition zone (TZ) lesions to guide decision for biopsy, which can improve the cost-effectiveness of resource utilisation.
Methods: The MRI scans of all patients who underwent MRI-ultrasound fusion targeted biopsy from 1 May 2016 to 31 December 2022 were retrospectively assessed by two board-certified abdominal radiologists. The following data were collected and analysed serum prostate-specific antigen, Prostatic Health Index (PHI), prostate volume, histological results, lesion size, location, diffusion-weighted imaging (DWI) parameter scores and overall PI-RADS score.
Results: Two hundred and fourteen TZ lesions were included. Among 131 PI-RADS 3 lesions, those with marked restricted diffusion (DWI score ≥4), diameter ≥1 cm, prostrate-specific antigen density (PSAD) ≥0.11 and PHI ≥34 were more likely to contain clinically significant prostate cancer (csPCa; P = 0.04, 0.02, 0.049 and 0.05, respectively), with areas under the receiver operating characteristics curve of 0.9, 0.76, 0.84 and 0.80, respectively. Apical lesions were more likely to contain csPCa compared to midgland or basal lesions (P = 0.01).
Conclusion: Clinical parameters (PSAD and PHI) and MRI features (lesion size, DWI score, lesion location) can be used to risk stratify PI-RADS 3 TZ lesions and guide decision for targeted biopsy.
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http://dx.doi.org/10.4103/singaporemedj.SMJ-2024-017 | DOI Listing |
Cancers (Basel)
December 2024
Department of Urology, Vall d'Hebron Hospital Campus, 08035 Barcelona, Spain.
Background: Inflammatory features can mimic PCa in suspicious MRI-lesions.
Objectives: To assess the incidence of inflammatory features in targeted biopsies to suspicious lesions.
Methods: A prospective analysis was conducted of 531 MRI-suspicious lesions with Prostate Imaging-Reporting and Data System (PI-RADS) scores of 3 to 5 in 364 men suspected of having PCa.
Diagnostics (Basel)
January 2025
Department of Medical Imaging, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
: Prostate cancer (PCa) is the most frequent neoplasia in the male population. According to the International Society of Urological Pathology (ISUP), PCa can be divided into two major groups, based on their prognosis and treatment options. Multiparametric magnetic resonance imaging (mpMRI) holds a central role in PCa assessment; however, it does not have a one-to-one correspondence with the histopathological grading of tumors.
View Article and Find Full Text PDFJ Comput Assist Tomogr
November 2024
From the Department of Radiology, Mayo Clinic, Rochester, MN.
Objectives: The aims of the study are to develop a prostate cancer risk prediction model that combines clinical and magnetic resonance imaging (MRI)-related findings and to assess the impact of adding Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions-level findings on its diagnostic performance.
Methods: This 3-center retrospective study included prostate MRI examinations performed with clinical suspicion of clinically significant prostate cancer (csPCa) between 2018 and 2022. Pathological diagnosis within 1 year after the MRI was used to diagnose csPCa.
Fr J Urol
January 2025
Department of Urology, North Hospital, AP-HM, Marseille, France.
Introduction: A significant proportion of newly diagnosed prostate cancer (PCa) cases are slow growing with a low risk of metastatic progression. There is a lack of data concerning the optimal biopsy regimen for improving diagnosis yield in PI-RADS3 lesions. This study aimed to assess the diagnostic value of current biopsy regimens in PI-RADS 3 lesions and identify clinical predictors to improve clinically significant PCa (csPCa) detection.
View Article and Find Full Text PDFAcad Radiol
January 2025
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China (B.Z., F.M., X.S., S.L., Q.W.); Department of Urology, Guangdong Provincial People's Hospital, Southern Medical University, Guangzhou, Guangdong 510080, China (Q.W.). Electronic address:
Rationale And Objectives: To develop an automatic deep-radiomics framework that diagnoses and stratifies prostate cancer in patients with prostate-specific antigen (PSA) levels between 4 and 10 ng/mL.
Materials And Methods: A total of 1124 patients with histological results and PSA levels between 4 and 10 ng/mL were enrolled from one public dataset and two local institutions. An nnUNet was trained for prostate masks, and a feature extraction module identified suspicious lesion masks.
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