Incidental findings on multiparametric MRI performed for evaluation of prostate cancer
Autor: | John V. Thomas, Soroush Rais-Bahrami, Win Shun Lai, Jeffrey W. Nix, Rachael L. Sherrer |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Biopsy Urology Contrast Media Active surveillance of prostate cancer Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate medicine Humans Radiology Nuclear Medicine and imaging Clinical significance Multiparametric Magnetic Resonance Imaging Aged Retrospective Studies Cancer staging Aged 80 and over Incidental Findings Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Gastroenterology Prostatic Neoplasms Middle Aged medicine.disease Magnetic Resonance Imaging Extraprostatic medicine.anatomical_structure 030220 oncology & carcinogenesis Radiology business |
Zdroj: | Abdom Radiol (NY) |
ISSN: | 2366-0058 2366-004X |
DOI: | 10.1007/s00261-017-1237-x |
Popis: | PURPOSE: Multiparametric magnetic resonance imaging (mp-MRI) and MRI/Ultrasound (US) fusion-guided biopsy are relatively new techniques for improved detection, staging, and active surveillance of prostate cancer (PCa). As with all imaging modalities, MRI reveals incidental findings (IFs) which carry the risk of increased cost, patient anxiety, and iatrogenic morbidity due to workup of IFs. Herein, we report the IFs from 684 MRIs for evaluation of PCa and consider their characteristics and clinical significance. METHODS: Patients underwent mp-MRI prostate protocol incorporating triplanar T2-weighted, diffusion-weighted, and dynamic contrast-enhanced pelvic MRI as well as a post-contrast abdominopelvic MRI with the primary indication of detection or evaluation of PCa. A total of 684 consecutive prostate MRI reports performed in a series of 580 patients were reviewed. All extraprostatic findings reported were logged and then categorized by organ system and potential clinical significance. RESULTS: There were 349 true IFs found in 233 (40%) of the 580 patients. One hundred nineteen additional extraprostatic findings were unsuspected but directly related to PCa staging, while the 349 IFs were unrelated and thus truly incidental beyond study indication. While the majority of true IFs were non-urologic, only 6.6% of IFs were considered clinically significant, non-urologic findings, and more than a third of MRI reports had urologic IFs not related to PCa. CONCLUSIONS: Rates of incidental findings on prostate indication MRI are similar to other abdominopelvic imaging studies. However, only 6.6% of the IFs were considered to be clinically significant non-urologic findings. Further investigations are needed to assess downstream workup of these IFs and resulting costs. |
Databáze: | OpenAIRE |
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