The role of quantitative MRI-based prostate zonal parameters in predicting clinically significant prostate cancer

A U.S. cohort

Authors

  • Christina Sze Weil Cornel Medicine/New York Presbyterian Hospital
  • Aaron Brant Weil Cornel Medicine/New York Presbyterian Hospital
  • Jeffery P. Johnson Weil Cornel Medicine/New York Presbyterian Hospital
  • Zorawar Singh Northwell Health, NY
  • Gina DeMeo Weil Cornell Medical College
  • Joseph Moryousef McGill University
  • Kevin C. Zorn Centre Hospitalier de l'Université de Montréal
  • Naeem Bhojani Centre Hospitalier de l'Université de Montréal
  • Dean S. Elterman University of Toronto
  • Daniel Margolis New York Presbyterian Hospital
  • Bilal Chughtai Weil Cornel Medicine/New York Presbyterian Hospital

DOI:

https://doi.org/10.5489/cuaj.8195

Keywords:

prostate cancer, transition zone, prostate zones, elevated PSA, BPH

Abstract

INTRODUCTION: We aimed to investigate the clinical utility of quantitative prostatic zonal measurements on multiparametric magnetic resonance imaging (mpMRI) for the predication of clinically significant prostate cancer (csPCa).

METHODS: A retrospective, single-institution study included 144 men who underwent mpMRI from 2015–2017. Prostate zone parameters were measured on mpMRI. Correlation and multivariable analysis evaluated the relationship between prostate zone parameters and the presence of csPCa.

RESULTS: The mean age was 66.9±7.8 years old. The median (interquartile range [IQR]) prostate volume and prostate-specific antigen (PSA) were 51.6 ml (37.1–74.5) and 6.1 ng/ ml (4.5–8.2), respectively. Men with csPCa had significantly smaller total prostate volume (TPV), transitional zone volume (TZV), and transitional zone thickness (TZT), and larger transitional zone density (TZD) compared to those without PCa; however, on multivariate variable analysis, only TZD maintained significance. TZD had a comparable area under the curve to PSA density (PSAD) and PSA (0.74 vs. 0.73 vs. 0.60, respectively). In a subgroup analysis of men with PCa, PSAD and TZD were significantly higher in men with Gleason grade group (GG) ≥2 compared to those with GG <2 (p=0.002); however, this significance is not maintained on logistic regression in predicting GG.

CONCLUSIONS: Quantitative features of prostate zones on MRI may aid in identifying better predictors of csPCa. Zonal-based PSA density (TZD) may be a useful marker in identifying csPCa. Further exploration is needed to understand the clinical application of larger TZV in men with csPCa compared to those with insignificant disease.

Downloads

Download data is not yet available.

Downloads

Published

2023-04-11

How to Cite

Sze, . C., Brant, A., Johnson, J. P. ., Singh, Z. ., DeMeo, G. ., Moryousef, J., Zorn, K. C. ., Bhojani, N., Elterman, D. S., Margolis, D. ., & Chughtai, B. . (2023). The role of quantitative MRI-based prostate zonal parameters in predicting clinically significant prostate cancer: A U.S. cohort. Canadian Urological Association Journal, 17(7), E182–8. https://doi.org/10.5489/cuaj.8195

Issue

Vol. 17 No. 7 (2023): CUAJ July

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.