Differentiation of prostatitis and prostate cancer using the Prostate Imaging-Reporting and Data System (PI-RADS).

To determine if prostate cancer (PCa) and prostatitis can be differentiated by using PI-RADS.

3T MR images of 68 patients with 85 cancer suspicious lesions were analyzed. The findings were correlated with histopathology. T2w imaging (T2WI), diffusion weighted imaging (DWI), dynamic contrast enhancement (DCE), and MR-Spectroscopy (MRS) were acquired. Every lesion was given a single PI-RADS score for each parameter, as well as a sum score and a PI-RADS v2 score. Furthermore, T2-morphology, ADC-value, perfusion type, citrate/choline-level, and localization were evaluated.

44 of 85 lesions showed PCa (51.8%), 21 chronic prostatitis (24.7%), and 20 other benign tissue such as hyperplasia or fibromuscular tissue (23.5%). The single PI-RADS score for T2WI, DWI, DCE, as well as the aggregated score including and not including MRS, and the PI-RADS v2-score were all significantly higher for PCa than for prostatitis or other tissue (p<0.001). The single PI-RADS score for MRS and the PI-RADS sum score including MRS were significantly higher for prostatitis than for other tissue (p=0.029 and p=0.020), whereas the other parameters were not different. Prostatitis usually presented borderline pathological PI-RADS scores, showed restricted diffusion with ADC≥900mm(2)/s in 100% of cases, was more often indistinctly hypointense on T2WI (66.7%), and localized in the transitional zone (57.1%). An ADC≥900mm(2)/s achieved the highest predictive value for prostatitis (AUC=0.859).

Prostatitis can be differentiated from PCa using PI-RADS, since all available parameters are more distinct in cases of cancer. However, there is significant overlap between prostatitis and other benign findings, thus PI-RADS is only suitable to a limited extent for the primary assessment of prostatitis. Restricted diffusion with ADC≥900mm(2)/s is believed to be a good indicator for prostatitis. MRS can help to distinguish between prostatitis and other tissue.

European journal of radiology. 2016 Apr 29 [Epub]

Michael Meier-Schroers, Guido Kukuk, Karsten Wolter, Georges Decker, Stefan Fischer, Christian Marx, Frank Traeber, Alois Martin Sprinkart, Wolfgang Block, Hans Heinz Schild, Winfried Willinek

Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, University of Bonn, Sigmund-Freud-Str 25, 53127 Bonn, Germany., Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany. Electronic address: ., Department of Radiology, Neuroradiology, Sonography and Nuclear Medicine, Hospital of the Barmherzige Brüder Trier, Nordallee 1, 54292 Trier, Germany. Electronic address: .

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe