The impact of benign tissue within cancerous regions in the prostate: Characterizing sparse and dense prostate cancers on whole-mount histopathology and on multiparametric MRI

IF 2.1 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Olga Starobinets , Jeffry P. Simko , Matthew Gibbons , John Kurhanewicz , Peter R. Carroll , Susan M. Noworolski
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引用次数: 0

Abstract

Purpose

To establish the incidence, size, zonal location and Gleason Score(GS)/Gleason Grade Group(GG) of sparse versus dense prostate cancer (PCa) lesions and to identify the imaging characteristics of sparse versus dense cancers on multiparametric MRI (mpMRI).

Methods

Seventy-six men with untreated PCa were scanned prior to prostatectomy with endorectal-coil 3 T MRI including T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced MRI. Cancerous regions were outlined and graded on the whole-mount, processed specimens, with tissue compositions estimated. Regions with cancer comprising <50 % and ≥ 50 % of the tissue were considered sparse and dense respectively. Regions of interest (ROI) were manually drawn on T2-weighted MRI. Within each patient, area-weighted ROI averages were calculated for each imaging measure for each tissue type, GS/GG, and sparse/dense composition.

Results

A large number of cancer regions were identified on histopathology (n = 1193: 939 (peripheral zone (PZ)) and 254 (transition zone (TZ))). Thirty-seven percent of these lesions were sparse. Sparse lesions were primarily low-grade with the majority of PZ and 100 % of TZ sparse lesions ≤GS3 + 3/GG1. Dense lesions were significantly larger than sparse lesions in both PZ and TZ, p < 0.0001. On imaging, 246/45 PZ and 109/8 TZ dense/sparse 2D cancerous ROIs were drawn. Sparse GS3 + 3 and sparse ≥GS3 + 4 cancers did not have significantly different MRI intensities to dense GS3 + 3 cancers, while sparse GS3 + 3/GG1 cancers differed from benign, p < 0.05.

Conclusion

Histopathologically identified prostate cancer lesions were sparse in 37 % of cases. Sparse cancers were entirely low grade in TZ and predominantly low-grade in PZ and generally small, thus likely posing lower risk for spread and progression than dense lesions. Sparse lesions were not distinguishable from dense lesions on mpMRI, but could be distinguished from benign tissues.

前列腺癌区域内良性组织的影响:通过全片组织病理学和多参数磁共振成像鉴定稀疏和致密前列腺癌的特征
目的 确定稀疏与致密前列腺癌(PCa)病变的发生率、大小、分区位置和格里森评分(GS)/格里森分级组(GG),并确定多参数磁共振成像(mpMRI)上稀疏与致密癌症的成像特征。方法 在前列腺切除术前,对76名未经治疗的PCa男性患者进行肛门直肠内线圈3 T磁共振成像扫描,包括T2加权成像、弥散加权成像和动态对比增强磁共振成像。在经过处理的整块标本上对癌变区域进行勾画和分级,并对组织成分进行估算。癌症占组织50%和≥50%的区域分别被视为稀疏区和致密区。在 T2 加权磁共振成像上手动绘制感兴趣区(ROI)。在每位患者体内,针对每种组织类型、GS/GG 和稀疏/致密成分的每种成像测量值,计算区域加权 ROI 平均值:939个(外周区(PZ)和254个(过渡区(TZ)))。这些病灶中有 37% 为稀疏病灶。稀疏病变主要是低级别病变,大多数 PZ 和 100% TZ 稀疏病变≤GS3 + 3/GG1。在 PZ 和 TZ 中,密集病灶明显大于稀疏病灶,P < 0.0001。在成像中,绘制了246/45个PZ和109/8个TZ致密/稀疏二维癌变ROI。稀疏GS3 + 3和稀疏≥GS3 + 4癌症的磁共振成像强度与致密GS3 + 3癌症无明显差异,而稀疏GS3 + 3/GG1癌症则与良性不同,p <0.05。稀疏癌在 TZ 中完全是低级别,在 PZ 中主要是低级别,而且一般较小,因此扩散和进展的风险可能低于致密病灶。稀疏病灶在 mpMRI 上无法与致密病灶区分开来,但可以与良性组织区分开来。
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来源期刊
Magnetic resonance imaging
Magnetic resonance imaging 医学-核医学
CiteScore
4.70
自引率
4.00%
发文量
194
审稿时长
83 days
期刊介绍: Magnetic Resonance Imaging (MRI) is the first international multidisciplinary journal encompassing physical, life, and clinical science investigations as they relate to the development and use of magnetic resonance imaging. MRI is dedicated to both basic research, technological innovation and applications, providing a single forum for communication among radiologists, physicists, chemists, biochemists, biologists, engineers, internists, pathologists, physiologists, computer scientists, and mathematicians.
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