Multi-Parametric Prostate MRI Underestimates Tumor Size
By MedImaging International staff writers Posted on 11 Feb 2021 |
Image: mpMRI imaging measures prostate tumor size as smaller than true (Photo courtesy of Alamy)
A new study suggests that multi-parametric MRI (mpMRI) routinely measures radiologic tumor size (RTS) as smaller than actual pathologic tumor size (PTS).
Researchers at the David Geffen School of Medicine (Los Angeles, CA, USA) conducted a study involving in 441 consecutive patients with 461 prostate cancer lesions who were scheduled for radical prostatectomy. The aim of the study was to evaluate agreement between RTS (defined as maximum tumor diameter on mpMRI), and whole mount histopathology PTS. The disparity in size was assessed, and clinical, pathological, and radiographic predictors of pathological tumor size were examined.
The results showed that mean RTS (1.57cm) regularly underestimated mean PTS (2.37 cm), regardless of preoperative covariates, and the degree of underestimation increased with smaller RTS and lower PI-RADSv2 scores. PTS was also significantly larger for biopsy Gleason GG5 compared to GG1; PI-RADSv2 5 lesions compared to PI-RADSv2 4 lesions; and higher prostate specific antigen (PSA) density. The study was published in the February 2021 issue of Journal of Urology.
“Our study suggests that by relying on RTS alone we can only be sure of complete ablation of the mpMRI detected lesion if a large margin is used in the largest diameter, especially for tumors less than two cm,” concluded lead author Aydin Pooli, MD, and colleagues. “Smaller margins, although acceptable, will have a lower degree of certainty for complete ablation of the prostate lesion. Incorporating tracked biopsy around the mpMRI detected prostate lesion could help overcome the tumor characterization limitations.”
Multiparametric MRI refers to the multiple sequences required to make the diagnosis, consisting of both anatomic T1-weighted and T2-weighted MRI sequences, and functional sequences, such as diffusion-weighted imaging MRI and dynamic contrast-enhanced MRI. By combining different types of scans, a clearer picture of the scanned area becomes available. Injecting a contrast agent also helps to enhance the image.
Related Links:
David Geffen School of Medicine
Researchers at the David Geffen School of Medicine (Los Angeles, CA, USA) conducted a study involving in 441 consecutive patients with 461 prostate cancer lesions who were scheduled for radical prostatectomy. The aim of the study was to evaluate agreement between RTS (defined as maximum tumor diameter on mpMRI), and whole mount histopathology PTS. The disparity in size was assessed, and clinical, pathological, and radiographic predictors of pathological tumor size were examined.
The results showed that mean RTS (1.57cm) regularly underestimated mean PTS (2.37 cm), regardless of preoperative covariates, and the degree of underestimation increased with smaller RTS and lower PI-RADSv2 scores. PTS was also significantly larger for biopsy Gleason GG5 compared to GG1; PI-RADSv2 5 lesions compared to PI-RADSv2 4 lesions; and higher prostate specific antigen (PSA) density. The study was published in the February 2021 issue of Journal of Urology.
“Our study suggests that by relying on RTS alone we can only be sure of complete ablation of the mpMRI detected lesion if a large margin is used in the largest diameter, especially for tumors less than two cm,” concluded lead author Aydin Pooli, MD, and colleagues. “Smaller margins, although acceptable, will have a lower degree of certainty for complete ablation of the prostate lesion. Incorporating tracked biopsy around the mpMRI detected prostate lesion could help overcome the tumor characterization limitations.”
Multiparametric MRI refers to the multiple sequences required to make the diagnosis, consisting of both anatomic T1-weighted and T2-weighted MRI sequences, and functional sequences, such as diffusion-weighted imaging MRI and dynamic contrast-enhanced MRI. By combining different types of scans, a clearer picture of the scanned area becomes available. Injecting a contrast agent also helps to enhance the image.
Related Links:
David Geffen School of Medicine
Latest MRI News
- World's First Sensor Detects Errors in MRI Scans Using Laser Light and Gas
- Diamond Dust Could Offer New Contrast Agent Option for Future MRI Scans
- Combining MRI with PSA Testing Improves Clinical Outcomes for Prostate Cancer Patients
- PET/MRI Improves Diagnostic Accuracy for Prostate Cancer Patients
- Next Generation MR-Guided Focused Ultrasound Ushers In Future of Incisionless Neurosurgery
- Two-Part MRI Scan Detects Prostate Cancer More Quickly without Compromising Diagnostic Quality
- World’s Most Powerful MRI Machine Images Living Brain with Unrivaled Clarity
- New Whole-Body Imaging Technology Makes It Possible to View Inflammation on MRI Scan
- Combining Prostate MRI with Blood Test Can Avoid Unnecessary Prostate Biopsies
- New Treatment Combines MRI and Ultrasound to Control Prostate Cancer without Serious Side Effects
- MRI Improves Diagnosis and Treatment of Prostate Cancer
- Combined PET-MRI Scan Improves Treatment for Early Breast Cancer Patients
- 4D MRI Could Improve Clinical Assessment of Heart Blood Flow Abnormalities
- MRI-Guided Focused Ultrasound Therapy Shows Promise in Treating Prostate Cancer
- AI-Based MRI Tool Outperforms Current Brain Tumor Diagnosis Methods
- DW-MRI Lights up Small Ovarian Lesions like Light Bulbs