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Zawaideh JP, Caglic I, Sushentsev N, Priest AN, Warren AY, Carmisciano L, Barrett T. MRI assessment of seminal vesicle involvement by prostate cancer using T2 signal intensity and volume. Abdom Radiol (NY) 2024; 49:2534-2539. [PMID: 38734785 DOI: 10.1007/s00261-024-04349-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Seminal vesicle involvement (SVI) in patients with newly diagnosed prostate cancer is associated with high rates of treatment failure and tumor recurrence; correct identification of SVI allows for effective management decisions and surgical planning. METHODS This single-center retrospective study analyzed MR images of the seminal vesicles from patients undergoing radical prostatectomy with confirmed T3b disease, comparing them to a control group without SVI matched for age and Gleason grade with a final stage of T2 or T3a. Seminal vesicles were segmented by an experienced uroradiologist, "raw" and bladder-normalized T2 signal intensity, as well as SV volume, were obtained. RESULTS Among the 82 patients with SVI, 34 (41.6%) had unilateral invasion, and 48 (58.4%) had bilateral disease. There was no statistically significant difference in the degree of distension between normal and involved seminal vesicles (P = 0.08). Similarly, no statistically significant difference was identified in the raw SV T2 signal intensity (P = 0.09) between the groups. In the 159 patients analyzed, SVI was prospectively suspected in 10 of 82 patients (specificity, 100%; sensitivity, 12.2%). In all these cases, lesions macroscopically invaded the seminal vesicle, and the raw T2 signal intensity was significantly lower than that in the SVI and control groups (P = 0.02 and 0.01). CONCLUSION While signal intensity measurements in T2-weighted images may provide insight into T3b disease, our findings suggest that this data alone is insufficient to reliably predict SVI, indicating the need for further investigation and complementary diagnostic approaches.
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Affiliation(s)
- Jeries P Zawaideh
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Iztok Caglic
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
| | - Anne Y Warren
- Department of Pathology, Addenbrooke's Hospital, Cambridge, UK
| | - Luca Carmisciano
- Department of Health Sciences (DISSAL), Biostatistics Section, University of Genoa, Genoa, Italy
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK
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Loh CK, Chui JN, Zhuo KY, Canagasingham A, Guminski A, Delprado W, Eade T, Winter M. An elusive prostate tumour: Metastatic microcystic cribriform carcinoma presenting with imaging-histologic discordance. Urol Case Rep 2024; 53:102676. [PMID: 38420334 PMCID: PMC10900826 DOI: 10.1016/j.eucr.2024.102676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
Microcystic adenocarcinoma is an uncommon histologic variant of prostate carcinoma. Despite its rarity, it has gained increasing recognition over the past decade for its diagnostic challenges and unclear prognostic significance. Herein, we describe a rare case of metastatic microcystic prostate adenocarcinoma, presenting with discordance between imaging and histologic findings. This report highlights the diagnostic and therapeutic challenges of this pathological entity and the importance of multidisciplinary collaboration in the management of intermediate-risk prostate cancer.
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Affiliation(s)
- Chun Khai Loh
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Juanita Noeline Chui
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
| | - Kevin Yinkit Zhuo
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
| | - Ashan Canagasingham
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
| | - Alexander Guminski
- University of Sydney, Sydney, NSW, Australia
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Warick Delprado
- Douglas Hanly Moir Pathology (Sonic Healthcare), Macquarie Park, NSW, Australia
| | - Thomas Eade
- University of Sydney, Sydney, NSW, Australia
- Department of Radiation Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Matthew Winter
- Department of Urology, Royal North Shore Hospital, Sydney, NSW, Australia
- North Shore Urology Research Group, Sydney, NSW, Australia
- University of Sydney, Sydney, NSW, Australia
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Lin Y, Johnson LA, Fennessy FM, Turkbey B. Prostate Cancer Local Staging with Magnetic Resonance Imaging. Radiol Clin North Am 2024; 62:93-108. [PMID: 37973247 PMCID: PMC10656475 DOI: 10.1016/j.rcl.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Accurate determination of the local stage of prostate cancer is crucial for treatment planning and prognosis. The primary objective of local staging is to distinguish between organ-confined and locally advanced disease, with the latter carrying a worse clinical prognosis. The presence of locally advanced disease features of prostate cancer, such as extra-prostatic extension, seminal vesicle invasion, and positive surgical margin, can impact the choice of treatment. Over the past decade, multiparametric MRI (mpMRI) has become the preferred imaging modality for the local staging of prostate cancer and has been shown to provide accurate information on the location and extent of disease. It has demonstrated superior performance compared to staging based on traditional clinical nomograms. Despite being a relatively new technique, mpMRI has garnered considerable attention and ongoing investigations. Therefore, in this review, we will discuss the current use of mpMRI on prostate cancer local staging.
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Affiliation(s)
- Yue Lin
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA
| | - Latrice A Johnson
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA
| | - Fiona M Fennessy
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, 10 Center Drive, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892, USA.
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Carpagnano FA, Eusebi L, Tupputi U, Testini V, Giannubilo W, Bartelli F, Guglielmi G. Multiparametric MRI: Local Staging of Prostate Cancer. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-00374-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Multiparametric MRI - local staging of prostate cancer and beyond. Radiol Oncol 2019; 53:159-170. [PMID: 31103999 PMCID: PMC6572496 DOI: 10.2478/raon-2019-0021] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/15/2019] [Indexed: 02/07/2023] Open
Abstract
Background Accurate local staging is critical for treatment planning and prognosis in patients with prostate cancer (PCa). The primary aim is to differentiate between organ-confined and locally advanced disease with the latter carrying a worse clinical prognosis. Multiparametric MRI (mpMRI) is the imaging modality of choice for the local staging of PCa and has an incremental value in assessing pelvic nodal disease and bone involvement. It has shown superior performance compared to traditional staging based on clinical nomograms, and provides additional information on the site and extent of disease. MRI has a high specificity for diagnosing extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node (LN) metastases, however, sensitivity remains poor. As a result, extended pelvic LN dissection remains the gold standard for assessing pelvic nodal involvement, and there has been recent progress in developing advanced imaging techniques for more distal staging. Conclusions T2W-weighted imaging is the cornerstone for local staging of PCa. Imaging at 3T and incorporating both diffusion weighted and dynamic contrast enhanced imaging can further increase accuracy. "Next generation" imaging including whole body MRI and PET-MRI imaging using prostate specific membrane antigen (68Ga-PSMA), has shown promising for assessment of LN and bone involvement as compared to the traditional work-up using bone scintigraphy and body CT.
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de Rooij M, Hamoen EH, Witjes JA, Barentsz JO, Rovers MM. Accuracy of Magnetic Resonance Imaging for Local Staging of Prostate Cancer: A Diagnostic Meta-analysis. Eur Urol 2016. [DOI: 10.1016/j.eururo.2015.07.029] [Citation(s) in RCA: 366] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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AbdelMaboud NM, Elsaid HH, Aboubeih EA. The role of diffusion – Weighted MRI in evaluation of prostate cancer. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2013.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Roethke M, Kaufmann S, Kniess M, Ketelsen D, Claussen C, Schlemmer H, Stenzl A, Schilling D. Seminal Vesicle Invasion: Accuracy and Analysis of Infiltration Patterns with High-Spatial Resolution T2-Weighted Sequences on Endorectal Magnetic Resonance Imaging. Urol Int 2014; 92:294-9. [DOI: 10.1159/000353968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 06/20/2013] [Indexed: 11/19/2022]
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Jeong CW, Ku JH, Moon KC, Hong SK, Byun SS, Cho JY, Kim HH, Kim SH, Lee SE, Kwak C. Can Conventional Magnetic Resonance Imaging, Prostate Needle Biopsy, or Their Combination Predict the Laterality of Clinically Localized Prostate Cancer? Urology 2012; 79:1322-7. [DOI: 10.1016/j.urology.2012.01.080] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 01/13/2012] [Accepted: 01/13/2012] [Indexed: 01/24/2023]
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Dickinson L, Ahmed HU, Allen C, Barentsz JO, Carey B, Futterer JJ, Heijmink SW, Hoskin P, Kirkham AP, Padhani AR, Persad R, Puech P, Punwani S, Sohaib A, Tombal B, Villers A, Emberton M. Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: could standardization lead to improved utilization of imaging within the diagnostic pathway? J Magn Reson Imaging 2012; 37:48-58. [DOI: 10.1002/jmri.23689] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 03/30/2012] [Indexed: 01/06/2023] Open
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Braguet R, Brichart N, Haillot O, Guérif S, Fromont G, Doré B, Irani J. [Seminal vesicle biopsies: Interest in the prostate cancer staging before radiation therapy or brachytherapy]. Prog Urol 2011; 21:534-41. [PMID: 21872156 DOI: 10.1016/j.purol.2010.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/16/2010] [Accepted: 10/31/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Seminal vesicle biopsies (SVB) in the staging of prostate cancer are controversial. Our main objective was to assess their contribution before radiation therapy or brachytherapy. Our secondary objective was to compare pathologic findings of the SVB to the magnetic resonance imaging's (MRI) results. PATIENTS AND METHODS From 2000 to 2008, 135 men (median age: 70 years) with prostate cancer (cT1a to cT3) underwent SVB right and left. The median PSA was 12 ng/ml. The median Gleason score was 7. Forty-one patients had an endorectal MRI. The median follow-up was 47 months. RESULTS Seminal vesicle involvement was found in 10% of patients. In 9.2% of cases, the biopsy was not contributive. The risk of invasion was significantly associated with the stage T3, the Gleason score up to 7 and the percentage of prostate positive biopsies. A MRI was performed in 41 cases: the correlation between MRI and SVB for the invasion of seminal vesicle was significant but moderate (kappa=0.38). The complications rate of SVB was 10%. CONCLUSION SVB were a simple and profitable method. They have provided supplementary information that could improve the staging and that could lead to the make use of an appropriate treatment. This information was comparable to the information provided by MRI. Further studies should establish their role in relation to MRI and in particular confirm the best specificity of the SVB.
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Affiliation(s)
- R Braguet
- Service d'Urologie, Hôpital Bretonneau, CHU de Tours, 2 Boulevard Tonnelé, 37000 Tours, France.
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Kimura M, Tsivian M, Mouraviev V, Mayes JM, Price MM, Bannister MC, Madden JF, Wong TZ, Polascik TJ. Utilization of111In-Capromab pendetide SPECT-CT for detecting seminal vesicle invasion with recurrent prostate cancer after primaryin situtherapy. Int J Urol 2009; 16:971-5. [DOI: 10.1111/j.1442-2042.2009.02413.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Current status of MRI for the diagnosis, staging and prognosis of prostate cancer: implications for focal therapy and active surveillance. Curr Opin Urol 2009; 19:274-82. [PMID: 19325494 DOI: 10.1097/mou.0b013e328329a2ed] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW To review the current status of MRI techniques in identification of organ-confined prostate cancer with a focus on their implication for focal therapy and active surveillance. RECENT FINDINGS MRI is currently focusing on intraprostatic prostate cancer identification and at 1.5T, it provides excellent imaging of the whole gland including the challenging anterior part. Improvements in accuracy for cancer detection and volume estimation result from dynamic contrast-enhanced and diffusion-weighted MRI sequences. 3T MRI might improve cancer identification. Histological correlations showed high sensitivity and specificity for significant volume cancers larger than 0.5 cm3. Important knowledge on modelling of cancer morphology such as zone of origin and intraprostatic patterns of spread at histopathology was made available for imaging interpretation and treatment planning decision. MRI results allow focused use of biopsy which led to better cancer characterization such as extent and grade. Ongoing focal therapy protocols and active surveillance treatments should benefit from these imaging advances. SUMMARY At present, high-resolution MRI with pelvic coil appears to offer the most readily available and useful imaging. Future studies should work towards helping define standard, reproducible approaches to imaging and image reporting for research and clinical practice.
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Ren J, Huan Y, Wang H, Ge Y, Chang Y, Yin H, Sun L. Seminal vesicle invasion in prostate cancer: prediction with combined T2-weighted and diffusion-weighted MR imaging. Eur Radiol 2009; 19:2481-6. [PMID: 19513720 DOI: 10.1007/s00330-009-1428-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Accepted: 03/01/2009] [Indexed: 10/20/2022]
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Lemaitre L, Rouvière O, Penna-Renard R, Villers A, Puech P. L’IRM du cancer de la prostate : un changement de paradigme. ACTA ACUST UNITED AC 2008; 89:1053-64. [DOI: 10.1016/s0221-0363(08)73909-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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