Transition Zone Prostate Cancers: Features, Detection, Localization, and Staging at Endorectal MR Imaging

Akın, Oğuz; Sala, Evis; Moskowitz, Chaya S.; Kuroiwa, Kentaro; Ishill, Nicole; Pucar, Darko; Scardino, Peter T.; Hricak, Hedvig

doi:10.1148/radiol.2392050949

Cited by 358 publications

(266 citation statements)

References 41 publications

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“…26,27 And magnetic resonance imaging, the most successful imaging modality to date, has particular challenges identifying cancers in the prostate TZ. 26,28 On the basis of our current study and other published work, 7 even standard TRUS biopsies probably miss an unacceptably high amount of Gleason X6 cancer to definitively state a man has unifocal disease. TTMB-perhaps in conjunction with evolving imaging technologies-could be used as initial or repeat biopsy to provide reassurance that a patient is a good candidate for segmental rather than whole gland treatment.…”

Section: Potential Implicationssupporting

confidence: 50%

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Taira

Merrick

Galbreath

et al. 2009

Prostate Cancer Prostatic Dis

259

171

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Transrectal ultrasound (TRUS) biopsy can miss 20-30% of clinically significant cancers. We evaluate an alternative approach-transperineal template-guided mapping biopsy (TTMB) in the initial and repeat biopsy setting. From January 2005 through September 2008, 373 consecutive men underwent TTMB (294 men with X1 prior negative biopsy and 79 men as the initial biopsy). The location of each positive biopsy core, number of positive cores, and percent involvement of each core was recorded. Cancer detection rate for the initial biopsy was 75.9%. For men with 1, 2, and X3 prior negative biopsies detection rates were 55.5%, 41.7%, and 34.4%, respectively. In all, 55.5% of the cancers identified were Gleason X7. The majority of the cancers were multifocal. There was no significant change in the number of positive cores or Gleason score as the number of prior biopsies increased. The anterior and apical aspects of the prostate were among the most common cancer locations. TTMB provides a high rate of cancer detection as initial and repeat biopsy. TTMB was particularly effective at diagnosing anterior and apical cancer. TTMB may have particular application for men considering active surveillance, with prior negative TRUS biopsies, and those considering subtotal gland or other minimally invasive treatments.

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Section: Potential Implicationssupporting

confidence: 50%

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Taira

Merrick

Galbreath

et al. 2009

Prostate Cancer Prostatic Dis

259

171

View full text Add to dashboard Cite

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“…This finding is consistent with the results of Sato et al (16), who used a 1.5-T MR scanner, as well as Kim et al (24), who used a 3.0-T MR scanner. Although 65% of prostate cancers arise in the PZ, up to 30% arise in the TZ (31), and MR imaging is generally considered inadequate for use in the evaluation of TZ cancers because of the heterogeneously low T2 signal intensity in normal TZ (6), and the presence of benign prostatic hyperplasia in TZ (32,33). Findings from a recent study using T2-weighted imaging (6), however, suggest that MRI features, such as homogeneously low T2 signal intensity, ill-defined margins, and lack of capsule, can be useful in the detection of TZ tumors.…”

Section: Discussionmentioning

confidence: 99%

“…In normal subjects, T1-weighted images were assessed to confirm that none of the subjects showed signs of hemorrhage within the prostate, and T2-weighted images were assessed to confirm that none of the subjects displayed evidence of prostate tumors (6,7).…”

Section: Image Analysismentioning

confidence: 99%

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Apparent diffusion coefficient values in peripheral and transition zones of the prostate: Comparison between normal and malignant prostatic tissues and correlation with histologic grade

Tamada

Sone

et al. 2008

Magnetic Resonance Imaging

238

137

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Purpose:To investigate the utility of apparent diffusion coefficient (ADC) values for discriminating tumor in patients with prostate cancer from normal prostatic tissues in healthy adult men, and to identify correlations between ADC and histologic grade of prostate cancer. Materials and Methods:A total of 125 healthy male volunteers (mean age, 60 years; range, 50 -86 years) and 90 prostate cancer patients (mean age, 71 years; range, 51-88 years) underwent diffusion-weighted imaging (DWI) of the prostate with a single-shot echo-planar imaging sequence using b-factors of 0 and 800 sec/mm 2 . ADC was measured from two locations in the peripheral zone (PZ) and two locations in the central gland (CG) in normal subjects, and tumor locations of PZ or transition zone (TZ) in patients with prostate cancer. Results:Mean ADC values of tumor regions in both PZ (1.02 Ϯ 0.25 ϫ 10 Ϫ3 mm 2 /sec) and TZ (0.94 Ϯ 0.21 ϫ 10 Ϫ3 mm 2 /sec) were significantly lower than those in the corresponding normal regions (1.80 Ϯ 0.27 ϫ 10 Ϫ3 mm 2 /sec and 1.34 Ϯ 0.14 ϫ 10 Ϫ3 mm 2 /sec, respectively) (P Ͻ 0.0001 each). Furthermore, a significant negative correlation was identified between ADC in PZ cancer and tumor Gleason score ( ϭ Ϫ0.497, P Ͻ 0.0001). Conclusion:ADC values appear to provide acceptable diagnostic accuracy in both PZ and TZ.

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“…T 2 -weighted (T2W) MRI can depict prostate zonal anatomy (20,21). MRSI provides information about relative concentrations of cellular metabolites in the prostate (22,23).…”

mentioning

confidence: 99%

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

Nagarajan

Margolis

Raman

et al. 2012

Magnetic Resonance Imaging

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Purpose: To investigate functional changes in prostate cancer patients with three pathologically proven different Gleason scores (GS) (3þ3, 3þ4, and 4þ3) using magnetic resonance spectroscopic imaging (MRSI) and diffusionweighted imaging (DWI). Materials and Methods:In this study MRSI and DWI data were acquired in 41 prostate cancer patients using a 1.5T MRI scanner with a body matrix combined with an endorectal coil. The metabolite ratios of (ChoþCr)/Cit were calculated from the peak integrals of total choline (Cho), creatine (Cr), and citrate (Cit) in MRSI. Apparent diffusion coefficient (ADC) values were derived from DWI for three groups of Gleason scores. The sensitivity and specificity of MRSI and DWI in patients were calculated using receiver operating characteristic curve (ROC) analysis. Results:The mean and standard deviation of (ChoþCr)/ Cit ratios of GS 3þ3, GS 3þ4, and GS 4þ3 were: 0.44 6 0.02, 0.56 6 0.06, and 0.88 6 0.11, respectively. For the DWI, the mean and standard deviation of ADC values in GS 3þ3, GS 3þ4, and GS 4þ3 were: 1.13 6 0.11, 0.97 6 0.10, and 0.83 6 0.08 mm 2 /sec, respectively. Statistical significances were observed between the GS and metabolite ratio as well as ADC values and GS.Conclusion: Combined MRSI and DWI helps identify the presence and the proportion of aggressive cancer (ie, Gleason grade 4) that might not be apparent on biopsy sampling. This information can guide subsequent rebiopsy management, especially for active surveillance programs.

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Transition Zone Prostate Cancers: Features, Detection, Localization, and Staging at Endorectal MR Imaging

Abstract: MR imaging can be used to detect, localize, and stage transition zone prostate cancers.

Cited by 358 publications

References 41 publications

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

Apparent diffusion coefficient values in peripheral and transition zones of the prostate: Comparison between normal and malignant prostatic tissues and correlation with histologic grade

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

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