title: Nonvisible tumors on multiparametric magnetic resonance imaging does not predict low-risk prostate cancer.
abstract: OBJECTIVE
  To determine whether multiparametric MRI could help predict the diagnosis of low-risk prostate cancer (PCA).
  
  
  METHODS
  We retrospectively analyzed consecutive 623 patients with PCA who underwent multiparametric MRI before radical prostatectomy(RP). High-resolution T1- and T2-weighted, diffusion-weighted, and dynamic precontrast and postcontrast image sequences were obtained for each patient. Of the 623 patients, 177(28.4%) exhibited non visible tumors on MRI of clinical stage T1c. The imaging results were compared with the pathological findings with respect to both stage and Gleason scores (GS).
  
  
  RESULTS
  Of the 177 prostatectomy patients with non visible tumors on MRI, pathological findings resulted in the upgrading of 49(27.7%) patients to a sum of GS 7 or more. 101(57.1%) patients exhibited tumor volumes greater than 0.5cc. The biochemical recurrence rate was significantly higher in the pathological upgraded group compared with the nonupgraded group after a mean follow-up time of 29 months. In the multiple logistic analysis, non visible tumor on MRI was not a significant predictor of low-risk PCA.
  
  
  CONCLUSIONS
  Even though cancer foci were not visualized by postbiopsy MRI, the pathological tumor volumes and extent of GS upgrading were relatively high. Therefore, nonvisible tumors by multiparametric MRI do not appear to be predictive of low-risk PCA.
authors.affiliation: Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Urology, Gangnam Severance Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Kyo Chul
authors.initials: KC
authors.lastname: Koo
authors.affiliation: Department of Urology, Busan National University College of Medicine, Busan, South Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Urology, Gangnam Severance Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
keywords: Active surveillance; Low risk; Magnetic resonance imaging; Prostate cancer