Incidental findings on prostate MRI: a close look at the field of view in this anatomical region

Abstract

Magnetic resonance imaging (MRI) has been widely used as an advanced imaging modality to detect prostate cancer and indicate suspicious areas to guide biopsy procedures. The increasing number of prostate examinations with MRI has provided an opportunity to detect incidental lesions, and some might be very significant to elucidate patient symptoms or occult neoplastic process in the early stages. These incidental lesions might be located in the prostate gland, adjacent tissues, or organs around the prostate gland or out of the genitourinary system. The field of view of prostate MRI includes not only the prostate gland but also other critical pelvic organs in this specific anatomical region. Some of these incidental lesions might cause the same symptoms as prostate cancer and might explain the symptoms of the patient, and some might indicate early cancer stages located outside the prostate. Reporting these lesions might be life-saving by initiating early disease treatment. Awareness of the predicted locations of congenital anomalies would also be beneficial for the radiologists to mention these incidental findings.

Quantification and significance of extraprostatic findings on prostate MRI: a retrospective analysis and three-tier classification

“…For example, marked trabecular hypertrophy of the urinary bladder wall and the presence of diverticula correlate with urinary retention and the need for intervention [ 15 ]. There are also very rare findings that have been described previously but not detected in our cohort of patients, including periprostatic leiomyomas, lipomas, fibrous tumors, chordomas, gastrointestinal stromal tumors, and their malignant variants [ 16 , 17 ]. Clinicians should be advised that prostate MRI also depicts other structures and should be encouraged to request a second reading with a specific question which is occasionally done (mostly for musculoskeletal system and soft tissue).…”