Multi-parametric MRI without artificial erection for preoperative assessment of primary penile carcinoma: A pilot study on the correlation between imaging and histopathological findings

Marta D Switlyk; Andreas Hopland; Shivanthe Sivanesan; Bjørn Brennhovd; Fredrik Ottosson; Kjetil Berner; Ulrika Axcrona; Knut H Hole

doi:10.1016/j.ejro.2023.100478

Multi-parametric MRI without artificial erection for preoperative assessment of primary penile carcinoma: A pilot study on the correlation between imaging and histopathological findings

Eur J Radiol Open. 2023 Jan 28:10:100478. doi: 10.1016/j.ejro.2023.100478. eCollection 2023.

Authors

Marta D Switlyk¹, Andreas Hopland², Shivanthe Sivanesan^{2

3}, Bjørn Brennhovd², Fredrik Ottosson², Kjetil Berner⁴, Ulrika Axcrona⁵, Knut H Hole^{1

3}

Affiliations

¹ Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
² Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
³ Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Genitourinary Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
⁵ Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.

Abstract

Purpose: We aimed to evaluate the diagnostic potential of non-erectile multi-parametric magnetic resonance imaging (mpMRI) for preoperative assessment of primary penile squamous cell carcinoma (SCC).

Method: Twenty-five patients who underwent surgery for penile SCC were included. Preoperative mpMRI without artificial erection was performed in all patients. The preoperative MRI protocol consisted of high-resolution morphological and functional sequences (diffusion-weighted imaging and dynamic contrast-enhanced MRI perfusion) covering the penis and lower pelvis. T and N staging, according to the 8th edition of the Union for International Cancer Control TNM classification, as well as the largest diameter and thickness/infiltration depth of the primary lesions were determined in all patients. Imaging data were retrospectively collected and compared with the final histopathology reports.

Results: Very good agreement was observed between MRI and histopathology for the involvement of corpus spongiosum (p = 0.002) and good agreement was observed for the involvement of penile urethra and tunica albuginea/corpus cavernosum (p < 0.001 and p = 0.007, respectively). Good agreement was observed between MRI and histopathology for overall T staging and weaker, but still good agreement was observed for N staging (p < 0.001 and p = 0.002, respectively). A strong and significant correlation was observed between MRI and histopathology for the largest diameter and thickness/infiltration depth of the primary lesions (p < 0.001).

Conclusions: Good concordance was observed between MRI and histopathological findings. Our initial findings indicate that non-erectile mpMRI is useful in preoperative assessment of primary penile SCC.

Keywords: Histopathology; Multi-parametric MRI; Primary penile carcinoma; Surgery.