Apical periurethral transition zone lesions: MRI and histology findings.
12-Core systematic TRUS-guided biopsy
Apical periurethral TZ lesion
Prostate cancer
TRUS/MRI fusion-guided biopsy
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
pubmed:
31
8
2019
medline:
22
6
2021
entrez:
31
8
2019
Statut:
ppublish
Résumé
Apical periurethral transition zone (TZ) cancers can pose unique problems for surgery and radiation therapy. Here, we describe the appearance of such cancers on multiparametric MRI (mpMRI) and correlate this with histopathology derived from MRI-targeted biopsy. Between May 2011 and January 2019, a total of 4381 consecutive patients underwent 3 T mpMRI. Of these, 53 patients with 58 apical periurethral TZ lesions underwent TRUS/MRI fusion-guided biopsy and 12-core systematic TRUS-guided biopsy. Correlation was made with patient age, PSA, PSA density, whole prostate volume, and Gleason scores. A total 53 men (median age 68 years, median PSA 7.94 ng/ml) were identified as having at least one apical periurethral TZ lesion on mpMRI and 5 (9%) patients had more than one apical periurethral lesion. Thus, 58 lesions were identified in 53 patients. Of these 37/53 patients (69%) and 40/58 lesions were positive at biopsy for prostate cancer. Seven were diagnosed by 12-core systematic TRUS-guided biopsy and 34 were diagnosed by TRUS/MRI fusion-guided biopsy. Gleason score was ≥ 3 + 4 in 34/58 (58%) lesions. Identification of apical periurethral TZ prostate cancers is important to help guide surgical and radiation therapy as these tumors are adjacent to critical structures. Because of the tendency to undersample the periurethral zone during TRUS biopsy, MRI-guided biopsy is particularly helpful for detecting apical periurethral TZ prostate cancers many of which prove to be clinically significant.
Identifiants
pubmed: 31468153
doi: 10.1007/s00261-019-02194-x
pii: 10.1007/s00261-019-02194-x
pmc: PMC8274956
mid: NIHMS1708347
doi:
Types de publication
Journal Article
Research Support, N.I.H., Intramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
3258-3264Subventions
Organisme : Intramural NIH HHS
ID : ZIA BC011081
Pays : United States
Organisme : Intramural NIH HHS
ID : ZID BC011242
Pays : United States
Organisme : Intramural NIH HHS
ID : Z01 BC010655
Pays : United States
Organisme : Intramural NIH HHS
ID : ZIA CL040015
Pays : United States
Organisme : Intramural NIH HHS
ID : ZIE SC000853
Pays : United States
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