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Morphometric analysis of prostate zonal anatomy using magnetic resonance imaging: impact on age‐related changes in patients in Japan and the USA
Author(s) -
Matsugasumi Toru,
Fujihara Atsuko,
Ushijima So,
Kanazawa Motohiro,
Yamada Yasuhiro,
Shiraishi Takumi,
Hongo Fumiya,
Kamoi Kazumi,
Okihara Koji,
Castro Abreu Andre Luis,
Oishi Masakatsu,
Shin Toshitaka,
Palmer Suzanne,
Gill Inderbir S.,
Ukimura Osamu
Publication year - 2017
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13823
Subject(s) - medicine , prostate , magnetic resonance imaging , urology , lower urinary tract symptoms , subgroup analysis , rank correlation , nuclear medicine , international prostate symptom score , radiology , confidence interval , cancer , machine learning , computer science
Objectives To evaluate the impact of morphometric magnetic resonance imaging ( MRI ) analysis of the prostate zonal anatomy on aging, prostatic hypertrophy and lower urinary tract symptoms in patients from Japan and the USA . Subjects and Methods A retrospective analysis of 307 men, including 156 men from Japan and 151 from the USA , who consecutively underwent 3‐Tesla MRI and International Prostate Symptom Score ( IPSS ) assessment because of elevated PSA levels. Using Synapse‐Vincent (Fujifilm), the prostatic zones were segmented in each axial step‐section of the T2‐weighted MRI to reconstruct a three‐dimensional model of the prostate, which was used to calculate: zonal volumes (whole‐gland prostate, transition zone and peripheral zone volumes); the presumed circle area ratio ( PCAR ); and PZ thickness. Bivariate associations were quantified using Spearman's rank correlation coefficients. Results The USA subgroup had a greater prostate volume (49 vs 42 mL; P = 0.003) and TZ volume (26 vs 20 mL; P < 0.001) than the Japan subgroup, with no difference in PZ volume (19 vs 20 mL; P = 0.2). There was no age‐related increase in PZ volume in either of the subgroups or in the entire cohort ( P = 0.9, P = 0.2, P = 0.3, respectively). PZ thickness had a significant negative correlation with PCAR ( P < 0.001) and TZ volume ( P < 0.001). The greater the increase in the TZ volume with the increase in PCAR , which probably correlates with obstructive pressure, the thinner the PZ became. PCAR had a significant positive correlation with IPSS ( P = 0.003) and obstructive symptoms ( P = 0.007), while PZ thickness had a significant negative correlation ( P = 0.018). Conclusions No age‐related increases and no differences between the Japanese and the US subgroups were found with regard to PZ volume. The more TZ volume increased, the higher the obstructive pressure and the thinner the PZ became; these changes were associated with increased obstructive symptoms. MRI analysis of prostate zonal anatomy enhanced our understanding of age‐related changes in morphology and urinary symptoms.