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In‐gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score
Author(s) -
Jyoti Rajeev,
Jioel Hamesh,
Haxhimolla Hodo Z
Publication year - 2017
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12555
Subject(s) - medicine , prostatitis , prostate , prostate cancer , biopsy , magnetic resonance imaging , radiology , prostate biopsy , neuroradiology , cancer , neurology , psychiatry
The recent literature has focussed predominantly on prostate cancer detection which has been revolutionized by multiparametric magnetic resonance imaging (mp MRI ). Due to an overlap of features, prostatitis may mimic prostate cancer on MRI , especially in patients with chronic prostatitis. We retrospectively analysed our in‐gantry MRI ‐guided biopsy ( MRGB ) results to determine incidental detection rate of prostatitis in Prostate Imaging Reporting and Data System ( PIRADS ) 3, 4 and 5 foci reported on diagnostic MRI of the prostate. Methods About 137 patients underwent in‐gantry MRGB for lesions with PIRADS score of 3 or above. All the biopsies were performed utilizing the dyna TRIM ™ system (Invio Inc, Germany) on a three‐tesla MRI scanner (Ingenia 3.0T, Philips, Netherlands) by a Radiologist and a Urologist. Results We biopsied 228 lesions in 137 patients. There were 55 lesions that returned positive for prostate cancer with a Gleason Score of 3 + 3 = 6 or above. There were 62 lesions that showed inflammation. The distribution of these lesions was 3 (5%) in the central zone, 32 (52%) in the transitional zone and 27 (43%) in the peripheral zone. Inflammation was found in 36 (58%) PIRADS 3 lesions, 24 (39%) PIRADS 4 lesions and 2 (3%) PIRADS 5 lesions on pre biopsy MRI evaluation. Conclusion In our series, biopsies which showed inflammation had a radiological appearance on mp MRI more likely of a PIRADS 3 or 4 lesions with only 3% of PIRADS 5 biopsies showing inflammation. This would suggest that a higher PIRADS score can more reliably differentiate between prostate cancer and prostatitis.