To analyse multiparametric magnetic resonance imaging (mpMRI) characteristics and appearance of histopathologically proven non-cancerous intraprostatic findings focussing on quantity of prostatitis and atrophy in the peripheral zone.
In this retrospective analysis consecutive patients with mpMRI followed by MRI/TRUS-fusion biopsy comprising targeted (TB) and systematic biopsy (SB) cores without prostate cancer (PC) at histopathology were included. Subgroup analysis was performed in younger men (≤50 years). The proportions of prostatitis and atrophy were quantified for each biopsy core based on histopathology. MRI findings in the peripheral zone (PZ) and index lesions (IL, most suspicious/representative lesion) were characterized regarding changes in T2w, ADC value, and enhancement of dynamic contrast enhancement (DCE) and correlated with quantity of prostatitis and atrophy.
Seventy-two patients were analysed. The median baseline characteristics were PSA 5.4 ng/ml (4.0-7.9), PI-RADS classification 3 (2-4), prostate volume 43 ml (33-57), and PSA density 0.13 ng/ml2 (0.10-0.19). Prostatitis was found in 44 % (n = 32) and atrophy in 65 % (n = 47) of cases. The quantity of atrophy demonstrated a significant correlation to T2w changes, ADC increase and DCE enhancement (p = 0.05, p = 0.05, p = 0.01), whereas quantity of prostatitis did not show any significant correlation to the MRI changes (p = 0.68, p = 0.58, p = 0.95). Quantity of prostatitis and atrophy increased with PI-RADS classification. Younger men had lower PSA (4.4 vs. 7.8 ml/ng; p < 0.001), smaller prostate volume (40 vs. 59 ml; p = 0.001), and lower PI-RADS classification (2-3 vs. 3-4; p = 0.005) and prostatitis and atrophy were less frequently observed (p ≤ 0.01, p = 0.03).
Quantity of atrophy and prostatitis had different influence on MRI characteristics and increased within higher PI-RADS classification. Younger men had diffuse hypointense changes at T2w images, but less quantity of prostatitis and atrophy.
European journal of radiology. 2023 Oct 18 [Epub ahead of print]
R Al-Monajjed, J P Radtke, M Thomas, M Boschheidgen, L R Drewes, T Ullrich, T Rau, I Esposito, G Antoch, P Albers, C Lopez-Cotarelo, L Schimmöller
University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany; Cantonal Hospital Aarau, Department of Urology, CH-5000 Aarau, Switzerland., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany., University Dusseldorf, Medical Faculty, Department of Pathology, D-40225 Dusseldorf, Germany., University Dusseldorf, Medical Faculty, Department of Pathology, D-40225 Dusseldorf, Germany; Institute of Pathology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany. Electronic address: .