University of Oulu

Tonttila, P.P., Ahtikoski, A., Kuisma, M., Pääkkö, E., Hirvikoski, P. and Vaarala, M.H. (2019), Multiparametric MRI prior to radical prostatectomy identifies intraductal and cribriform growth patterns in prostate cancer. BJU Int, 124: 992-998. doi:10.1111/bju.14812

Multiparametric MRI prior to radical prostatectomy identifies intraductal and cribriform growth patterns in prostate cancer

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Author: Tonttila, Panu P.1; Ahtikoski, Anne1; Kuisma, Mari1;
Organizations: 1Departments of Urology, Pathology and Radiology, and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020051230818
Language: English
Published: John Wiley & Sons, 2019
Publish Date: 2020-05-18
Description:

Abstract

Objectives: To evaluate the diagnostic value of multiparametric prostate magnetic resonance imaging (mpMRI) prior to radical prostatectomy with curative intent for the detection of cribriform architecture (CA) and intraductal prostate cancer (IDC), which have recently been demonstrated to be adverse pathological features.

Patients and Methods: The study included 124 men who underwent mpMRI prior to radical prostatectomy at our centre. Preoperative mpMRI, prostatectomy histology and clinical follow‐up details were reviewed retrospectively. The diagnostic value of mpMRI was evaluated on the basis of the detection rate. Secondly, the prognostic significance of CA/IDC among grade group (GG)2 cancers with regard to biochemical recurrence (BCR)‐free survival was assessed using Kaplan–Meier analysis, with the log rank test and Fisher’s exact test.

Results: Pathological examination of radical prostatectomy specimens identified CA/IDC in 89 of 124 cases (71%) and mpMRI identified 86/95 of tumours including any CA/IDC with a sensitivity of 90.5% (95% confidence interval 82.8–95.6%). When localization of the lesions was compared, there was an association between the highest Prostate Imaging‐Reporting and Data System classification and the highest pathological grade in 106 of the 124 cases (85.5%). In patients with GG2 lesions, BCR occurred in 11 of 31 (35.5%) with CA/IDC and two of 21 (9.5%) without CA/IDC (P = 0.034).

Conclusion: Multiparametric MRI has good sensitivity for detection of pathological primary prostate cancer, including most cases with CA/IDC; however, reliable prediction of GG2 tumours with CA/IDC for individual risk stratification remains challenging.

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Series: BJU international
ISSN: 1464-4096
ISSN-E: 1464-410X
ISSN-L: 1464-4096
Volume: 124
Issue: 6
Pages: 992 - 998
DOI: 10.1111/bju.14812
OADOI: https://oadoi.org/10.1111/bju.14812
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Funding: This work was supported in part by the Finnish Urological Association and the Scholarship Fund of the University of Oulu (Maija‐Liisa Kovala Fund) to Panu Tonttila.
Copyright information: © 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Tonttila, P.P., Ahtikoski, A., Kuisma, M., Pääkkö, E., Hirvikoski, P. and Vaarala, M.H. (2019), Multiparametric MRI prior to radical prostatectomy identifies intraductal and cribriform growth patterns in prostate cancer. BJU Int, 124: 992-998, which has been published in final form at https://doi.org/10.1111/bju.14812. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.