Defining prostate cancer size and treatment margin for focal therapy: does intralesional heterogeneity impact the performance of multiparametric MRI?

Objectives To evaluate the impact of intralesional heterogeneity on the performance of multiparametric magnetic resonance imaging (mpMRI) in determining cancer extent and treatment margins for focal therapy (FT) of prostate cancer. Patients and Methods We identified men who underwent primary radical...

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Bibliographic Details
Published in:BJU international 2021-08, Vol.128 (2), p.178-186
Main Authors: Aslim, Edwin Jonathan, Law, Yu Xi Terence, Fook‐Chong, Stephanie Man Chung, Ho, Henry Sun Sien, Yuen, John Shyi Peng, Lau, Weber Kam On, Lee, Lui Shiong, Cheng, Christopher Wai Sam, Ngo, Nye Thane, Law, Yan Mee, Tay, Kae Jack
Format: Article
Language:English
Subjects:
Atrophy
cancer size
focal therapy
high grade
Histology
Lesions
Magnetic resonance imaging
multiparametric MRI
Original
PCSM
Prostate cancer
ProstateCancer
Prostatectomy
treatment margin
Tumors
uroonc
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Summary:Objectives To evaluate the impact of intralesional heterogeneity on the performance of multiparametric magnetic resonance imaging (mpMRI) in determining cancer extent and treatment margins for focal therapy (FT) of prostate cancer. Patients and Methods We identified men who underwent primary radical prostatectomy for organ‐ confined prostate cancer over a 3‐year period. Cancer foci on whole‐mount histology were marked out, coding low‐grade (LG; Gleason 3) and high‐grade (HG; Gleason 4–5) components separately. Measurements of entire tumours were grouped according to intralesional proportion of HG cancer: 0%, 95% of the HG cancer components. Conclusions Multiparametric MRI performance in estimating prostate cancer size, and consequently the treatment margin for FT, is impacted by tumour size and the intralesional heterogeneity of cancer grades.
ISSN:1464-4096
1464-410X
DOI:10.1111/bju.15355