Natural history of prostatic lesions on serial multiparametric magnetic resonance imaging

  • Samrad Ghavimi University of British Columbia
  • Hamidreza Abdi
  • Jennifer Waterhouse
  • Richard Savdie
  • Silvia Chang
  • Alison Harris
  • Lindsay Machan
  • Martin Gleave
  • Alan I. So
  • Larry Goldenberg
  • Peter C. Black

Abstract

Introduction: The natural history of prostatic lesions identified on multiparametric magnetic resonance imaging (mpMRI) is largely unknown. We aimed to describe changes observed over time on serial MRI.

Methods: All patients with ≥2 MRI studies between 2008 and 2015 at our institution were identified. MRI progression was defined as an increase in Prostate Imaging Reporting and Data System (PI-RADS; version 2) or size of existing lesions, or the appearance of a new lesion PIRADS ≥4. Patients on active surveillance (AS) were analyzed for correlation of MRI progression to biopsy reclassification.

Results: A total of 83 patients (54 on AS and 29 for diagnostic purposes) underwent serial MRI, with a mean interval of 1.9 years between scans. At baseline, 115 lesions (66 index, 49 non-index) were identified. Index lesions were more likely than non-index lesions to increase in size ≥2 mm (36.2 vs. 7.3%; p=0.002). Overall progression was more likely to be seen among the index cohort (34.8 vs. 7.6%; p<0.001). New lesions with PI-RADS ≥4 were seen on second imaging in 13 (16.5%) men, and became the index lesion in 29 cases (34.9%). Eighteen men on AS showed evidence of MRI progression (five with new lesions, 13 with progression of a previous lesion). Biopsy reclassification was present in three men (16.7%) with and seven men without MRI progression (19.4%).

Conclusions: Overall changes in size and PI-RADS scores of index lesions on MRI were small. New lesions were common, but usually did not alter management.

Published
2018-03-26
How to Cite
Ghavimi, S., Abdi, H., Waterhouse, J., Savdie, R., Chang, S., Harris, A., Machan, L., Gleave, M., So, A. I., Goldenberg, L., & Black, P. C. (2018). Natural history of prostatic lesions on serial multiparametric magnetic resonance imaging. Canadian Urological Association Journal, 12(8). https://doi.org/10.5489/cuaj.4859
Section
Original Research