Dominant intraprostatic cancer confirmed by direct MRI-guided biopsy: Concordance with histopathological findings

Clin Imaging. 2018 Sep-Oct:51:273-278. doi: 10.1016/j.clinimag.2018.06.008. Epub 2018 Jun 9.

Abstract

Purpose: To investigate the concordance between dominant intraprostatic cancer seen on endorectal multiparametric MRI and confirmed by MRI-targeted biopsy with histopathological findings at radical prostatectomy, since existing literature has emphasized the miss rather than the concordance rate of MRI.

Materials and methods: We retrospectively identified 20 patients who underwent radical prostatectomy after a dominant intraprostatic cancer focus was identified at endorectal multiparametric MRI and confirmed by MRI-targeted biopsy. Concordance was determined by comparing the location and Gleason grade group of dominant tumor at MRI with the location and Gleason grade group determined at histopathological review.

Results: Mean patient age was 65 years (range, 48 to 76) and median serum prostatic specific antigen level was 9.4 ng/mL (range, 4.6 to 58.0). In all 20 patients, the location of dominant tumor based on MRI and targeted biopsy corresponded with the dominant tumor location at histopathology. In 9 patients, Gleason grade group was the same at targeted biopsy and final histopathology. In 9 patients, final Gleason grade group was higher and in two patients it was lower.

Conclusion: Our preliminary results suggest dominant tumor as determined by endorectal multiparametric MRI and confirmed by a positive MRI-targeted biopsy has high concordance with histopathological findings at radical prostatectomy for location, and reasonable concordance for Gleason grade group.

Keywords: MRI; MRI targeted biopsy; Prostate cancer.

MeSH terms

  • Aged
  • Humans
  • Image-Guided Biopsy / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Prostatectomy*
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery
  • Retrospective Studies