Benign prostatic hyperplasia: value of MR imaging for determining histologic type.

Ishida, Jun; Sugimura, Kazuro; Okizuka, Hiromi; Kaji, Yuichi; Moriyama, Masahiro; Nagaoka, Sakae; Mizutani, Masako; Ishida, Takuya

doi:10.1148/radiology.190.2.7506836

Cited by 47 publications

(29 citation statements)

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“…33 The transition zone usually shows hyperplastic changes, including glandular and connective tissues, in elderly patients. 34 This is probably the main reason for higher ADC values for the normal peripheral zone than for the nonmalignant transition zone. 15,17,18,23,25 The detection of cancer of the prostate gland on the ADC map depends on the conspicuity of the cancer lesions in comparison with the surrounding noncancer areas.…”

Section: Discussionmentioning

confidence: 99%

Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

et al. 2011

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“…Immediately before the MR imaging examination, 1 mg glucagon (Lilly, of diffusion-weighted (DW) MR imaging and dynamic contrast material-enhanced MR imaging were promising, the CG was usually regarded as histologically uniform, and a single diffusion or perfusion parameter was calculated to represent the entire benign CG (11)(12)(13)(14)(15). However, the benign CG is composed of two histologically distinct types of tissue: Glandular tissue, which is hyperintense on T2-weighted images, and stromal tissue, which is hypointense and can mimic CG cancer ( 16,17 ). To our knowledge, a dedicated study comparing DW and dynamic contrast-enhanced MR imaging features of different CG benign prostatic hyperplasia (BPH) subtypes and those of CG carcinoma has not been reported.…”

Section: Mr Imaging Protocolsmentioning

confidence: 99%

Prostate Cancer: Differentiation of Central Gland Cancer from Benign Prostatic Hyperplasia by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging

Oto

Kayhan²,

Jiang³

et al. 2010

Radiology

270

198

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Purpose:To analyze the diffusion and perfusion parameters of central gland (CG) prostate cancer, stromal hyperplasia (SH), and glandular hyperplasia (GH) and to determine the role of these parameters in the differentiation of CG cancer from benign CG hyperplasia. Materials and Methods:In this institutional review board-approved (with waiver of informed consent), HIPAA-compliant study, 38 foci of carcinoma, 38 SH nodules, and 38 GH nodules in the CG were analyzed in 49 patients (26 with CG carcinoma) who underwent preoperative endorectal magnetic resonance (MR) imaging and radical prostatectomy. All carcinomas and hyperplastic foci on MR images were localized on the basis of histopathologic correlation. The apparent diffusion coeffi cient (ADC), the contrast agent transfer rate between blood and tissue (K trans ), and extravascular extracellular fractional volume values for all carcinoma, SH, and GH foci were calculated. The mean, standard deviation, 95% confi dence interval (CI), and range of each parameter were calculated. Receiver operating characteristic (ROC) and multivariate logistic regression analyses were performed for differentiation of CG cancer from SH and GH foci. Results:The average ADCs ( 3 10 2 3 mm 2 /sec) were 1.05 (95% CI: 0.97, 1.11), 1.27 (95% CI: 1.20, 1.33), and 1.73 (95% CI: 1.64, 1.83), respectively, in CG carcinoma, SH foci, and GH foci and differed signifi cantly, yielding areas under the ROC curve (AUCs) of 0.99 and 0.78, respectively, for differentiation of carcinoma from GH and SH. Perfusion parameters were similar in CG carcinomas and SH foci, with K trans yielding the greatest AUCs (0.75 and 0.58, respectively). Adding K trans to ADC in ROC analysis to differentiate CG carcinoma from SH increased sensitivity from 38% to 57% at 90% specifi city without noticeably increasing the AUC (0.79). Conclusion:ADCs differ signifi cantly between CG carcinoma, SH, and GH, and the use of them can improve the differentiation of CG cancer from SH and GH. Combining K trans with ADC can potentially improve the detection of CG cancer.

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“…They observed a direct relationship between the change in Q max following the administration of terazosin and the amount of smooth muscle in the prostate, indicating that the mechanism of ·-blocker is related to the area density of prostatic smooth muscle. On the other hand, MRI of BPH is reported to be useful for the prediction of histological components in the prostate inner gland [7,8]. The areas of the prostate with abundant glandular elements appear to have the highest intensity, and fibromuscular tissue shows a lower intensity by MRI.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of α-Blocker Responders in Men with Benign Prostatic Hyperplasia

Mimata

Satoh²,

Ohno³

et al. 2002

Urol Int

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Background: Currently, α-blocker is becoming first-line drug therapy for benign prostatic hyperplasia (BPH). Although highly effective results are obtained with this therapy, a difference between the objective and subjective response rates is reported. To prevent unnecessary medical treatment and to predict the α-blocker response, we characterized the clinical features of α-blocker responders in men with BPH. Methods: Twenty-two men were consecutively enrolled in this study and received tamsulosin 0.2 mg once daily for 4–6 weeks. The primary measures of efficacy were maximum urinary flow rate (Q_max) determined from the flow measurements and international prostate symptom score (IPSS). Those with an increase in Q_max of ≧30% from baseline and a decrease in IPSS of ≧25% from baseline were defined as Q_max responders and IPSS responders, respectively. Clinical findings such as age, pretreatment IPSS and Q_max, serum prostate-specific antigen (PSA), total prostate volume, transition zone (TZ) volume, TZ index and T₂-weighted magnetic resonance image (MRI) of the prostate TZ were compared between responders and non-responders for both criteria. Results: In 17 of 22 (77.2%) patients IPSS improved by ≧25%. In 9 of 22 (40.9%) patients Q_max improved by ≧30%. There were no differences in clinical findings between IPSS responders and non-responders. On the contrary, Q_max responders showed smaller total prostate and TZ volumes, a smaller TZ index and a lower intensity of the TZ in MRI than Q_max non-responders. Conclusions: Determination of the prostate volume and MRI findings of the inner prostate gland were useful in predicting Q_max responders to the α-blocker in men with BPH. In contrast, there were no clinical characteristics of the IPSS responders. IPSS responders without a Q_max response should be closely followed while continuing the α-blocker therapy for a long duration.

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Benign prostatic hyperplasia: value of MR imaging for determining histologic type.

Abstract: MR imaging appears to be useful for choosing the type of pharmacotherapy performed because accurate histologic assessment is possible.

Cited by 47 publications

References 0 publications

Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

Prostate Cancer: Differentiation of Central Gland Cancer from Benign Prostatic Hyperplasia by Using Diffusion-weighted and Dynamic Contrast-enhanced MR Imaging

Clinical Characteristics of α-Blocker Responders in Men with Benign Prostatic Hyperplasia

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