A significant proportion of prostate cancers are non-aggressive, low-grade tumours (Gleason score [GS] ≤ 6), defined as non-clinically significant PCa (ncsPCa). Due to increasingly accepted new conservative approaches as treatment protocols for these low grade prostate cancers, it is today more important to diagnose tumor aggressiveness correctly, in other words, to differentiate ncsPCa from clinically significant prostate cancer (csPCa), defined as GS ≥ 7, to apply the appropriate treatment modalities and reduce overtreatment or ineffective treatment results [1-4]. As a non-invasive and easily applicable diagnostic...

In total, thirty-three male patients diagnosed with PCa by both 12-core standard TRUS biopsy and MRI-US real-time fusion computerized needle navigation (confined to suspected lesions, defined as PI-RADS [Prostate Imaging Reporting and Data System] 3 or above on multiparametric MRI) between January 2017 and May 2018 were identified from the institutional imaging database [16]. Among these patients, 4 cases were excluded for the central gland location of the lesions, 1 case was excluded for the immense artefacts present due to a metallic hip implant, and...

Overall, the 26 patients in the present study (median age 68 years; IQR 62–71 years) had 38 lesions (20 ncsPCa, Gleason scores (GS) < 7; 18 csPCa, GS ≥ 7) in the peripheral zone. In the csPCa group (18 lesions), 2 had a GS of 3+4 (11%), 4 had a GS of 4+3 (22%), 8 had a GS of 4+4 (44.5%), 3 had a GS of 4+5 (17%), and 1 lesion had a GS of 5+4 (5.5%). The median PSA levels were 5.83 ng/ml (IQR...

As a result, the present study showed that Ktrans and ADC had significant correlations with GS. The combination of these metrics had the highest diagnostic accuracy results, which shows the potential of assessing the tumour aggressiveness of peripheral zone PCa by means of multiparametric MRI. On the other hand, normalized version of Ktrans can be used as adjunct and complimentary measurements to increase the sensitivity when discriminating between ncsPCa and csPCa by eliminating discrepancies between different DCE-MRI methods. More studies conducted with larger cohorts are...

Emetullah Cindil, MD, Radiology Specialist, Gazi University Faculty of Medicine, Department of Radiology, Ankara, Turkey Address: Gazi University, Faculty of Medicine 06500, Besevler, Ankara, Turkey Telephone:00-90-312-2025151 E-mail: [email protected]

1. References 1. Siegel RL, Miller KD, Jemal A. Cancer statistics 2015. CA Cancer J Clin 2015;65 (1): 5–29 2. Ahmed HU, Akin O, Coleman JA, et al. Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer. BJU Int 2012;109:1636–1647 3. Thostrup M, Thomsen FB, Iversen P et al (2018) Active surveillance for localized prostate cancer: update of a prospective single-center cohort. Scandinavian J of Urology 52:14–19 4. Arumainayagam N, Ahmed HU, Moore CM, et al. Multiparametric MR imaging for detection of...