Focal prostatic atrophy: mimicry of prostatic cancer on TRUS and 3D-MRSI studies

Prando, Adilson; Billis, Athanase

doi:10.1007/s00261-008-9382-x

Cited by 31 publications

(14 citation statements)

References 13 publications

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“…Despite the relatively high specificity of MR spectroscopy, false-positive MR spectroscopic interpretations can result from inclusion of signal from the seminal vesicles, stromal BPH, prostatitis, and focal prostatic atrophy (44). Although the (choline + creatine)/citrate ratio can be low or normal in BPH (Fig 3), this is the case predominantly in glandular BPH, which has high levels of citrate and polyamines as a result of the histologic composition of hyperplastic glandular tissue.…”

Section: Mr Spectroscopymentioning

confidence: 90%

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Bonekamp¹,

Jacobs²,

El-Khouli³

et al. 2011

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Prostate cancer is the most frequently diagnosed cancer in males and the second leading cause of cancer-related death in men. Assessment of prostate cancer can be divided into detection, localization, and staging; accurate assessment is a prerequisite for optimal clinical management and therapy selection. Magnetic resonance (MR) imaging has been shown to be of particular help in localization and staging of prostate cancer. Traditional prostate MR imaging has been based on morphologic imaging with standard T1-weighted and T2-weighted sequences, which has limited accuracy. Recent advances include additional functional and physiologic MR imaging techniques (diffusionweighted imaging, MR spectroscopy, and perfusion imaging), which allow extension of the obtainable information beyond anatomic assessment. Multiparametric MR imaging provides the highest accuracy in diagnosis and staging of prostate cancer. In addition, improvements in MR imaging hardware and software (3-T vs 1.5-T imaging) continue to improve spatial and temporal resolution and the signal-to-noise ratio of MR imaging examinations. Another recent advancement in the field is MR imaging guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonographyguided systematic biopsy. Abbreviations: ADC = apparent diffusion coefficient, BPH = benign prostatic hyperplasia, DCE = dynamic contrast-enhanced, DRE = digital rectal examination, EES = extracellular-extravascular space, PSA = prostate-specific antigen, ROI = region of interest, SNR = signal-to-noise ratio, TKCM = tracer kinetic compartmental model

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Section: Mr Spectroscopymentioning

confidence: 90%

Advancements in MR Imaging of the Prostate: From Diagnosis to Interventions

Bonekamp¹,

Jacobs²,

El-Khouli³

et al. 2011

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“…There is a positive association between the extent of atrophy at biopsy and the total or free serum elevation of PSA level (52). This is possibly due to PSA release from damaged epithelial cells in atrophic acini.…”

Section: Mimics Of Prostate Carcinoma At Mr Imagingmentioning

confidence: 99%

Benign Conditions That Mimic Prostate Carcinoma: MR Imaging Features with Histopathologic Correlation

Kitzing¹,

Prando²,

Varol³

et al. 2016

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Multiparametric magnetic resonance (MR) imaging combines anatomic and functional imaging techniques for evaluating the prostate and is increasingly being used in diagnosis and management of prostate cancer. A wide spectrum of anatomic and pathologic processes in the prostate may masquerade as prostate cancer, complicating the imaging interpretation. The histopathologic and imaging findings of these potential mimics are reviewed. These entities include the anterior fibromuscular stroma, surgical capsule, central zone, periprostatic vein, periprostatic lymph nodes, benign prostatic hyperplasia (BPH), atrophy, necrosis, calcification, hemorrhage, and prostatitis. An understanding of the prostate zonal anatomy is helpful in distinguishing the anatomic entities from prostate cancer. The anterior fibromuscular stroma, surgical capsule, and central zone are characteristic anatomic features of the prostate with associated low T2 signal intensity due to dense fibromuscular tissue or complex crowded glandular tissue. BPH, atrophy, necrosis, calcification, and hemorrhage all have characteristic features with one or more individual multiparametric MR imaging modalities. Prostatitis constitutes a heterogeneous group of infective and inflammatory conditions including acute and chronic bacterial prostatitis, infective and noninfective granulomatous prostatitis, and malacoplakia. These entities are associated with variable clinical manifestations and are characterized by the histologic hallmark of marked inflammatory cellular infiltration. In some cases, these entities are indistinguishable from prostate cancer at multiparametric MR imaging and may even exhibit extraprostatic extension and lymphadenopathy, mimicking locally advanced prostate cancer. It is important for the radiologists interpreting prostate MR images to be aware of these pitfalls for accurate interpretation.

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“…MRS has a high specificity for prostate cancer detection, but it has a low sensitivity because of partial volume effects and strong signals from the surrounding tissue, especially the seminal vesicles, stromal benign prostatic hyperplasia and prostatitis (60).…”

Section: Mrsmentioning

confidence: 99%