Pitfalls with MRI evaluation of prostate cancer detection: comparison of findings with histopathological assessment of retropubic radical prostatectomy specimens.
BACKGROUND
To assess differences between MRI findings and histopathologically defined prostate cancer localization, we compared clinical results with mapping of radical prostatectomy specimens, and conducted a retrospective MRI cancer localization re-assessment by a urologist-technician after surgery.


METHODS
We performed MRI for a total of 37 suspected prostate cancer patients. Subsequently, all underwent retropubic radical prostatectomy after prostate biopsy for confirmation of the diagnosis. All the specimens were studied histopathologically with serial sectioning using a whole organ approach.


RESULTS
Of the 37 patients, 26 had positive MRI findings. All the surgical specimens contained cancerous lesions, and 23 had multiple foci. Twenty-four of the MRI-positive cases (92.3%) demonstrated coincidence of both MRI and histopathologically defined lesions. In the single focus cases, 78.6% (11/14) demonstrated exact coincidence, but in the multifocal cases there were no cases with exact coincidence of MRI and histopathological findings (0/23).


CONCLUSIONS
MRI evaluation cannot be considered an effective diagnostic tool in itself for detection of prostate cancers because sensitivity is far from satisfactory, especially in multi-focal cases.
Okamura
Takehiko
T
Division of Urology, Meijo Hospital, Nagoya, Japan. hiko0512@yahoo.co.jp
Umemoto
Yukihiro
Y
Yamashita
Kazuaki
K
Suzuki
Shugo
S
Shirai
Tomoyuki
T
Hashimoto
Yoshihiro
Y
Kohri
Kenjiro
K
D000368:Aged; D001706:Biopsy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity