Keywords:
Cancer, Biopsy, MR, CT, Genital / Reproductive system male, Oncology, Abdomen
Authors:
P. Vivian, S. Dupre; QLD/AU
DOI:
10.1594/ranzcr2016/R-0059
Results
48 PI-RADS 4/5 lesions were detected in 47 patients with an average age of 66.9 years old.
One patient was excluded due to marked streak artefact on CT from hip prostheses.
One of the patients had 2 separate prostate lesions,
however,
only the larger of the 2 lesions was included in the study.
Isolated PI-RADS 4/5 lesions were reported in the remaining patients.
19 out of 46 lesions (41.3%) were detected on CT; 13 (28%) were scored “2” (Subtle) and 6 (13%) as “3” (Overt).
There was very high agreement between the readers for lesion detection (93.5%; Kappa value 0.885,
p <0.0005).
A consensus between the readers was reached for discordant scores.
Lesions were detected on CT in all allocated zones.
(See Fig.
2) The majority of the MRI detected lesions were located posterior-laterally in the peripheral zone (21/46 - 45%).
Of these 21 lesions,
12 lesions (57.1%) were visible on CT (scored 2 or 3),
which was significantly higher than the 7 visible lesions (28%) in all other locations combined (P-value 0.046).
(See Fig.
3) No other statistically significant association was found between visibility on CT and location.
Histology from TRUS biopsy or radical resection was obtained in 95% of the case.
The dominant pattern was Gleason 4 (57%) followed by and Gleason 3 (43%).
A relationship between Gleason score and lesion visibility was not investigated as it was difficult in some cases to precisely correlate the imaging-detected lesion with the histology specimens (particularly in cases of multi-focal carcinoma found on histology).