MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette–Guérin therapy

Suzuki, Tomohiro; Takeuchi, Mitsuru; Naiki, Taku; Kawai, Noriyasu; Kohri, Kenjiro; Hara, Masaki; Shibamoto, Yuta

doi:10.1016/j.crad.2012.12.005

Cited by 30 publications

(39 citation statements)

References 11 publications

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“…In a number of cases, no specific cause can be established and they are classified as idiopathic. It has to be emphasized that prior BCG therapy may be a major but not the only cause of GP in western societies, and that GP can present several months to years after BCG treatment, as seen in our case 2 and documented in prior reports [11,12]. GP shares many clinical and imaging characteristics with PCa, but management differs significantly, with most cases of GP resolving spontaneously or after therapy of an underlying infection.…”

Section: Discussionsupporting

confidence: 52%

Granulomatous Prostatitis Mimicking Prostate Cancer on Magnetic Resonance Imaging: Report of Two Cases

Wibmer¹,

Vargas²,

Hricak³

2017

Rejr

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agnetic resonance imaging is a method of choice in the diagnosis of prostate cancer in case of primary cancer and to determine the staging. But MR-signs inherent in the classical for prostate cancer are not absolutely specific and can be caused by non-malignant pathological process, such as granulomatous prostatitis. This paper presents two clinical cases of patients with histologically confirmed granulomatous prostatitis mimicking prostate cancer and reviewed published literature on this issue. агнитно-резонансная томография давно стала методом выбора при диагностике рака простаты как на этапе первичного выявления опухоли, так и на этапе определения стадирования. Но МР-признаки, присущие классическому течению рака предстательной железы не являются абсолютно специфичными, и могут быть вызваны незлокачественным патологическим процессом, таким как гранулематозный простатит.В данной работе представлены два клинических примера магнитно-резонансной томографии пациентов с гистологически подтвержденным гранулематозным простатитом, имитирующим рак предстательной железы и рассмотрена опубликованная литература по данной проблеме.Ключевые слова: гранулематозный простатит, рак предстательной железы, МРТ предстательной железы.

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Section: Discussionsupporting

confidence: 52%

Granulomatous Prostatitis Mimicking Prostate Cancer on Magnetic Resonance Imaging: Report of Two Cases

Wibmer¹,

Vargas²,

Hricak³

2017

Rejr

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“…Notable findings from this study included six of ten patients who demonstrated CGP in with a diffuse shape, lower signal intensity (SI) than bone marrow on T2W, and higher SI on DWI. 7 The other observed characteristics included 3 CGP lesions that were nodular in appearance but did not have congruence in their SIs for either T2W or DWI. Another recent report of 5 patients found a slight decrease in mean Apparent Diffusion Coefficients (ADC) derived from diffusion weighted MRI for CGP versus prostate cancer with moderate dynamic contrast enhancement (DCE) of CGP lesions, again overlapping with PCa.…”

Section: Discussionmentioning

confidence: 99%

Changes Observed in Multiparametric Prostate Magnetic Resonance Imaging Characteristics Correlate With Histopathological Development of Chronic Granulomatous Prostatitis After Intravesical Bacillus Calmette-Guerin Therapy

Logan¹,

Walton-Diaz²,

Rais‐Bahrami³

et al. 2014

Journal of Computer Assisted Tomography

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Administration of Bacillus Calmette-Guerin (BCG) has been shown to cause granulomatous prostatitis, a rare inflammatory process that can be mistaken for prostate cancer (PCa). We present a case of a 78-year-old male on active surveillance (AS) for PCa with a subsequent diagnosis of high-grade urothelial carcinoma. Following intravesical BCG therapy, he developed chronic granulomatous prostatitis (CGP). We present serial MRI and biopsy data demonstrating the time interval between BCG administration and the manifestation of CGP.

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“…The MR imaging features of BCG-induced GP have been reported to be nonspecific (9, 11). In general, BCG-induced GP shows a tumor-like appearance with hypo-signal intensity on T2WI, similar to that of prostate cancer, in foci that involve the peripheral zone.…”

Section: Discussionmentioning

confidence: 99%

“…Lesion shape and size were evaluated on T2WI according to the reports of Suzuki et al (9). The degree of signal intensity on T1WI and T2WI was determined visually compared with that of the residual normal peripheral zone.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported previously that magnetic resonance (MR) imaging demonstrates a diffuse decrease in signal intensity or well-circumscribed low signal intensity nodules in the peripheral zone on T2-weighted images (T2WI) (8). Suzuki et al (9) reported non-contrast enhanced MR imaging features of BCG-induced GP in 10 patients. They concluded three main findings of diffuse, nodular, and cystic with mural nodules.…”

Section: Introductionmentioning

confidence: 99%

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Multiphase Contrast-Enhanced Magnetic Resonance Imaging Features of Bacillus Calmette-Guérin-Induced Granulomatous Prostatitis in Five Patients

et al. 2015

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ObjectiveTo evaluate the multiphase contrast-enhanced magnetic resonance (MR) imaging features of Bacillus Calmette-Guérin (BCG)-induced granulomatous prostatitis (GP).Materials and MethodsMagnetic resonance images obtained from five patients with histopathologically proven BCG-induced GP were retrospectively analyzed for tumor location, size, signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI), apparent diffusion coefficient (ADC) value, and appearance on gadolinium-enhanced multiphase images. MR imaging findings were compared with histopathological findings.ResultsBacillus Calmette-Guérin-induced GP (size range, 9-40 mm; mean, 21.2 mm) were identified in the peripheral zone in all patients. The T2WI showed lower signal intensity compared with the normal peripheral zone. The DWIs demonstrated high signal intensity and low ADC values (range, 0.44-0.68 × 10-3 mm2/sec; mean, 0.56 × 10-3 mm2/sec), which corresponded to GP. Gadolinium-enhanced multiphase MR imaging performed in five patients showed early and prolonged ring enhancement in all cases of GP. Granulomatous tissues with central caseation necrosis were identified histologically, which corresponded to ring enhancement and a central low intensity area on gadolinium-enhanced MR imaging. The findings on T2WI, DWI, and gadolinium-enhanced images became gradually obscured with time.ConclusionBacillus Calmette-Guérin-induced GP demonstrates early and prolonged ring enhancement on gadolinium-enhanced MR imaging which might be a key finding to differentiate it from prostate cancer.

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MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette–Guérin therapy

Cited by 30 publications

References 11 publications

Granulomatous Prostatitis Mimicking Prostate Cancer on Magnetic Resonance Imaging: Report of Two Cases

Granulomatous Prostatitis Mimicking Prostate Cancer on Magnetic Resonance Imaging: Report of Two Cases

Changes Observed in Multiparametric Prostate Magnetic Resonance Imaging Characteristics Correlate With Histopathological Development of Chronic Granulomatous Prostatitis After Intravesical Bacillus Calmette-Guerin Therapy

Multiphase Contrast-Enhanced Magnetic Resonance Imaging Features of Bacillus Calmette-Guérin-Induced Granulomatous Prostatitis in Five Patients

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