To investigate the application of multiparametric MRI (mp-MRI) for comprehensive evaluation of the correlation between the characteristics of the transitional zone and the International Prostate Symptom Score (IPSS) in patients with benign prostatic hyperplasia (BPH).
We retrospectively recruited 210 patients with biopsy-proven BPH who underwent preoperative mp-MRI and were assigned an IPSS. The evaluation indicators included prostate volumetric parameters [total prostate volume (TPV), transition zone volume (TZV), and transition zone index (TZI, TZI=TZV/TPV)], prostate morphological parameters [intravesical prostatic protrusion (IPP), and presumed circle area ratio (PCAR)] and prostate compositional parameters [apparent diffusion coefficient (ADC), and mean signal intensity of T2WI (mean-SI-T2WI)]. The Pearson (r) correlation coefficient, one-way analysis of variance (ANOVA) and multiple linear regression analysis were used to build a regression model for evaluating the correlation between MRI-derived parameters and IPSS, IPSS-storage symptom (IPSS-ss), IPSS-voiding symptom (IPSS-vs).
Significant correlations were found between IPSS, IPSS-ss, IPSS-vs and prostate MRI-derived parameters, including TPV (r=0.350; r=0.466; r=0.225, P<0.001), TZV (r=0.374; r=0.492; r=0.243, P<0.001), TZI (r=0.383; r=0.313; r=0.354, P<0.001), PCAR (r=0.481; r=0.356; r=0.469, P<0.001), ADC(r=-0.198; r=-0.053; r=-0.239, P<0.05) and mean-SI-T2WI (r=-0.626; r=-0.310; r=-0.687, P<0.001) respectively. Based on multiple linear regression analysis, the impact of mean-SI-T2WI and TZI on total IPSS were statistically significant (P<0.05), and the regression equation established with the analysis [IPSS=39.224+8.469×TZI+(-0.09)×(mean-SI-T2WI)] was statistically significant (F=104.995, P<0.001).
Mp-MRI could be used to evaluate the volume and morphology of BPH. In particular, mean-SI-T2WI and ADC could be used to describe the internal composition of the prostate. The imaging parameters were effective for evaluating BPH.
Urology. 2023 Apr 21 [Epub ahead of print]
Jianli Yang, Qiaozhi Ma, Jiqiang Liu, Haiping Zu, Siqing Dong, Ying Liu, Gang Guo, Binbin Nie, Xuetao Mu
Department of Radiology, the Training Site for Postgraduate of Jinzhou Medical University, Liaoning 121000, China; Department of Radiology, Changji branch of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang 831100, China., Department of Radiology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China., Department of Magnetic Resonance Imaging, The Third Affiliated Hospital Of Xinxiang Medical University, Xin Xiang, Henan 453003, China., Department of Radiology, the Training Site for Postgraduate of Jinzhou Medical University, Liaoning 121000, China; Department of Radiology, Specialized Medical Center of the Rocket Army, Beijing 100088, China., Department of Radiology, the Training Site for Postgraduate of Jinzhou Medical University, Liaoning 121000, China., Weifang Medical University, Wei Fang, Shandong 261053, China., Department of Urology, the Third Medical Center of Chinese PLA General Hospital, Beijing 100069, China., Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China., Department of Radiology, Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China. Electronic address: .