Magnetic resonance imaging (MRI) is often used in the detection and management of prostate cancer, but the method often underestimates tumor size, a study in the Journal of Urology showing.
Magnetic resonance imaging (MRI) is often used in the detection and management of prostate cancer, but the method often underestimates tumor size, a study from the UCLA Comprehensive Cancer Center found Jonsson.
The study, published in Journal of Urology, aimed at assessing radiologic tumor size vs. true pathological tumor size in patients with prostate cancer and identifying pathological tumor size predictors.
Researchers evaluated a group of 441 men with biopsy-confirmed prostate cancer and 3 or higher index lesions based on the Prostate Image Reporting System and Data version 2 (PI-RADSv2) who underwent radical prostatectomy after that. They described the size of a radiologic tumor as the highest tumor diameter confirmed by the MRI and compared these measurements with those found in the full-blown histopathology after resection.
The analysis included 461 injuries from the identified 441 patients. The average size of a radiologic tumor was 1.57 cm, whereas the average size of a pathological tumor was 2.37 cm. Although tumor size was consistently measured in the radiologic setting, tumors that were smaller and had lower PI-RADSv2 scores tended to be lower in size than others.
In cases where tumors were classified as stage 5 on the Gleason Stage Group (GG), the size of pathological tumors was larger compared to stage 1 GG tumors, with an average change of 0.37 cm (P. = .014). Level 5 lesions on the PI-RADSv2 index also had pathology tumor sizes larger than PI-RADSv2 4 lesions, with an average change of 0.26 (P. = .006). Tumors with a specific prostate-specific antigen density were also larger.
Overall, there was little correlation between radiologic tumor size and pathological tumor size in the group. The researchers found correlation coefficients ranging from 0.1 to 0.65. An inaccurate tumor measurement can make it difficult for physicians to see where the outer edges of the tumor end and healthy tension begins, which can lead to inadequate treatment when the measurements are not estimated. .
“Multimetric magnetic resonance imaging often underestimates pathological tumor size and the degree of non-metastasis increases with smaller radiologic tumor size and lower PI-RADSv2 scores,” co- the authors closed.
For the treatment of smaller tumors and those rated low on the PI-RADSv2 scale, they suggest that a larger ablation margin may be required as physicians estimate treatment treatment margins. focus.
Information
Pooli A, Johnson DC, Shirk J, et al. Predicting pathological tumor size in prostate cancer is based on multiparametric prostate magnetic resonance imaging and preoperative findings. J Urol. 2021; 205 (2): 444-451. doi: 10.1097 / JU.0000000000001389