Prostate magnetic resonance imaging findings in patients treated for testosterone deficiency while on active surveillance for low-risk prostate cancer.
To investigate the multiparametric prostate magnetic resonance imaging (mpMRI) findings in patients treated with testosterone replacement therapy (TRT) while on active surveillance for low-risk prostate cancer.



We retrospectively reviewed 12 patients who underwent mpMRI before and after TRT while on active surveillance. Changes in serum testosterone level, prostate-specific antigen (PSA), prostate biopsy findings, prostate volume, and Prostate Imaging Reporting and Data System Version 2 (PI-RADSv2) score before and after TRT were summarized.



After TRT, there was a significant increase in serum testosterone (516.5ng/dl vs. 203.0ng/dl), PSA (4.2ng/ml vs. 3.3ng/ml), and prostate volume (55.2cm3vs. 39.4cm3). In total, 2 patients had biopsy progression during the study period. The PI-RADSv2 scores before and after TRT were unchanged in 10/12 patients; none of these demonstrated biopsy progression on post-TRT. The PI-RADSv2 scores increased after TRT in 2/12 patients; both showed Gleason score upgrade on follow-up biopsy. Of these 2 patients, 1 patient underwent radical treatment due to clinical progression. The area under the curve for detecting biopsy progression calculated from PI-RADSv2 score after TRT was 0.90, which was better than that calculated from post-TRT PSA level (0.48).



After TRT, mpMRI findings remained stable in patients without biopsy progression, whereas PI-RADSv2 score increase was identified in patients with Gleason score upgrade on follow-up biopsy.
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Urology, Tokyo Medical University, Tokyo, Japan.
Takeshi
T
Hashimoto
Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer, New York, NY.
Krishnan
K
Rahul
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Toshikazu
T
Takeda
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Nicole
N
Benfante
Sexual and Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer, New York, NY.
John P
JP
Mulhall
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.
Hedvig
H
Hricak
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
James A
JA
Eastham
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: vargasah@mskcc.org.
Hebert Alberto
HA
Vargas
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology*; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D000075203:Contraindications, Drug; D018450:Disease Progression; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D012189:Retrospective Studies; D012306:Risk; D013739:Testosterone / Q000009:adverse effects / Q000172:deficiency* / Q000627:therapeutic use; D057832:Watchful Waiting
D013739:Testosterone
Active surveillance; Multiparametric prostate magnetic resonance imaging; Prostate cancer; Testosterone deficiency; Testosterone replacement therapy
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