Conventional MRI Capabilities in the Diagnosis of Prostate Cancer in the Transition Zone
Hong Li1,
Kazuro Sugimura1,
Yasushi Kaji1,
Yuri Kitamura1,
Masahiko Fujii1,
Isao Hara2 and
Mayumi Tachibana3
1 Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2
Kusunoki-cho chuo-ku, Kobe, Hyogo, Japan 650-0017.
2 Department of Urology, Kobe University Graduate School of Medicine, Kobe,
Japan.
3 Division of Pathology, Kobe University Graduate School of Medicine, Kobe,
Japan.
View larger version (18K):
[in a new window]
|
Fig. 1A —Receiver operating characteristic (ROC) curves from data in
Table 5. Graph of three ROC
curves was constructed according to base criteria in
Table 5. It shows comparison of
base criteria of A, B, and C. Base criterion B is preferable to base criteria
A and C.
|
|
View larger version (19K):
[in a new window]
|
Fig. 1B —Receiver operating characteristic (ROC) curves from data in
Table 5. Graph of three ROC
curves was constructed on combined criteria in
Table 5. Line F is preferable
to lines D and E in sensitivity but lower in specificity for detection of
transition zone cancer.
|
|
View larger version (18K):
[in a new window]
|
Fig. 1C —Receiver operating characteristic (ROC) curves from data in
Table 5. Graph of three ROC
curves was obtained from subgroups G, H, and I according to data in
Table 5. Curve G shows higher
sensitivity than curves H and I, but for clinically important accuracy
subgroup H is better than subgroups G and I.
|
|
View larger version (157K):
[in a new window]
|
Fig. 2A —Prostatic cancer in 68-year-old man with prostate-specific antigen
level of 19.3 ng/mL and negative findings on endorectal sonography-guided
biopsy. Stage is T2b. No suspicious findings were seen on digital rectal
examination or endorectal sonography. Axial and sagittal T2-weighted images
(TR/TE, 5,000/155 and 4,700/119; echo-train length, 8) show uniform
hypointense area with irregular margin in anterior location of inner gland,
which extends toward anterior fibromuscular stroma (arrows).
Heterogeneous decreased intensity area is seen in right peripheral zone.
|
|
View larger version (152K):
[in a new window]
|
Fig. 2B —Prostatic cancer in 68-year-old man with prostate-specific antigen
level of 19.3 ng/mL and negative findings on endorectal sonography-guided
biopsy. Stage is T2b. No suspicious findings were seen on digital rectal
examination or endorectal sonography. Axial and sagittal T2-weighted images
(TR/TE, 5,000/155 and 4,700/119; echo-train length, 8) show uniform
hypointense area with irregular margin in anterior location of inner gland,
which extends toward anterior fibromuscular stroma (arrows).
Heterogeneous decreased intensity area is seen in right peripheral zone.
|
|
View larger version (163K):
[in a new window]
|
Fig. 2C —Prostatic cancer in 68-year-old man with prostate-specific antigen
level of 19.3 ng/mL and negative findings on endorectal sonography-guided
biopsy. Stage is T2b. No suspicious findings were seen on digital rectal
examination or endorectal sonography. Contrast-enhanced T1-weighted image
(600/20) with fat suppression shows homogeneous enhancement of lesion at inner
gland and enhancement of both peripheral zones.
|
|
View larger version (152K):
[in a new window]
|
Fig. 2D —Prostatic cancer in 68-year-old man with prostate-specific antigen
level of 19.3 ng/mL and negative findings on endorectal sonography-guided
biopsy. Stage is T2b. No suspicious findings were seen on digital rectal
examination or endorectal sonography. Histopathologic specimen obtained at
corresponding level reveals moderately differentiated adenocarcinoma in
anterior position of inner gland (arrow). Tumor size is 35 x 15
mm. Two small tumor foci indicating prostatic intraepithelial neoplasia are
seen in background of both peripheral zones (arrowheads) (original
magnification, H and E staining).
|
|
View larger version (166K):
[in a new window]
|
Fig. 3A —70-year-old man with stage T2b cancer. Prostate-specific antigen is
11.8 ng/mL. Axial T2-weighted image (TR/TE, 5,550/137; echo-train length, 8)
illustrates uniform low-intensity abnormality in inner gland at right
(arrows).
|
|
View larger version (161K):
[in a new window]
|
Fig. 3B —70-year-old man with stage T2b cancer. Prostate-specific antigen is
11.8 ng/mL. Contrast-enhanced T1-weighted image (550/12) with fat suppression
shows homogeneous enhancement confined to inner gland.
|
|
View larger version (173K):
[in a new window]
|
Fig. 3C —70-year-old man with stage T2b cancer. Prostate-specific antigen is
11.8 ng/mL. Histopathologic specimen at level of tumor shows adenocarcinoma
present at inner gland. Tumor size is 24 x 16 mm (original
magnification, H and E staining).
|
|
View larger version (177K):
[in a new window]
|
Fig. 4A —68-year-old man with stage T2b cancer. Prostate-specific antigen was
17 ng/mL. Axial and sagittal T2-weighted images (TR/TE, 4,500/132 and
4,500/136, respectively; echo-train length, 8) show band-shaped hypointense
area in anterior of inner gland (arrows).
|
|
View larger version (200K):
[in a new window]
|
Fig. 4B —68-year-old man with stage T2b cancer. Prostate-specific antigen was
17 ng/mL. Axial and sagittal T2-weighted images (TR/TE, 4,500/132 and
4,500/136, respectively; echo-train length, 8) show band-shaped hypointense
area in anterior of inner gland (arrows).
|
|
View larger version (109K):
[in a new window]
|
Fig. 4C —68-year-old man with stage T2b cancer. Prostate-specific antigen was
17 ng/mL. Hypointense area shows homogeneous enhancement with irregular margin
on contrast-enhanced T1-weighted image with fat suppression (517/18).
|
|
View larger version (153K):
[in a new window]
|
Fig. 4D —68-year-old man with stage T2b cancer. Prostate-specific antigen was
17 ng/mL. Histopathologic section reveals moderately differentiated
adenocarcinoma. Anterior fibromuscular stroma is ruptured (arrow)
(original magnification, H and E stain).
|
|
View larger version (135K):
[in a new window]
|
Fig. 5A —59-year-old man with stage T2a cancer. Prostate-specific antigen was
71.4 ng/mL. Axial T2-weighted image (TR/TE, 4,617/102; echo-train length, 8)
shows large heterogeneous low signal intensity on right side of inner gland
(arrows).
|
|
View larger version (134K):
[in a new window]
|
Fig. 5B —59-year-old man with stage T2a cancer. Prostate-specific antigen was
71.4 ng/mL. After contrast material administration, homogeneous enhancement is
shown in anterior of lesion (arrowheads) and inhomogeneous
enhancement in posterior of lesion (arrows) (617/12).
|
|
View larger version (176K):
[in a new window]
|
Fig. 5C —59-year-old man with stage T2a cancer. Prostate-specific antigen was
71.4 ng/mL. Histopathologic specimen obtained at corresponding level reveals
moderately differentiated adenocarcinoma originating from benign prostatic
hyperplasia nodule surrounded by capsule of benign prostatic hyperplasia
(arrowheads). Anterior fibromuscular stroma is ruptured. Tumor size
is 34 x 28 mm (original magnification, H and E staining).
|
|
View larger version (180K):
[in a new window]
|
Fig. 6A —73-year-old man with stage T2b cancer and false-negative
interpretation of benign lesion. Prostate-specific antigen is 10 ng/mL.
Regular margin of intermediate-signal-intensity nodule (arrows) is
shown in inner gland on left on axial T2-weighted image (TR/TE, 4,000/120;
echo-train length, 12).
|
|
View larger version (129K):
[in a new window]
|
Fig. 6B —73-year-old man with stage T2b cancer and false-negative
interpretation of benign lesion. Prostate-specific antigen is 10 ng/mL.
Postcontrast T1-weighted image with fat suppression (TR/TE, 672/17) shows no
enhancement with regular margin.
|
|
View larger version (138K):
[in a new window]
|
Fig. 6C —73-year-old man with stage T2b cancer and false-negative
interpretation of benign lesion. Prostate-specific antigen is 10 ng/mL.
Histopathologic specimens show hypernephroid pattern of adenocarcinoma. Left
of anterior fibromuscular stroma is ruptured (arrowhead, C)
(original magnification, x10; H and E stain).
|
|
View larger version (177K):
[in a new window]
|
Fig. 6D —73-year-old man with stage T2b cancer and false-negative
interpretation of benign lesion. Prostate-specific antigen is 10 ng/mL.
Histopathologic specimens show hypernephroid pattern of adenocarcinoma. Left
of anterior fibromuscular stroma is ruptured (arrowhead, C)
(original magnification, x10; H and E stain).
|
|
View larger version (180K):
[in a new window]
|
Fig. 7A —72-year-old man with prostatic cancer located only in peripheral
zone, stage T2b. Prostate-specific antigen is 8.8 ng/mL. Nodular whorl area
with low signal intensity presents on inner gland on axial T2-weighted image
(arrows) (TR/TE, 4,350/100; echo-train length, 12).
|
|
View larger version (165K):
[in a new window]
|
Fig. 7B —72-year-old man with prostatic cancer located only in peripheral
zone, stage T2b. Prostate-specific antigen is 8.8 ng/mL. Nodule shows
homogeneous enhancement with regular edge on contrast-enhanced T1-weighted
image (550/11) (arrows).
|
|
View larger version (164K):
[in a new window]
|
Fig. 7C —72-year-old man with prostatic cancer located only in peripheral
zone, stage T2b. Prostate-specific antigen is 8.8 ng/mL. Transverse section of
prostate shows typical nodular benign prostatic hyperplasia
(arrowheads) (original magnification, H and E stain).
|
|
View larger version (132K):
[in a new window]
|
Fig. 8A —70-year-old man with stage T2b cancer. Prostate-specific antigen is
5.9 ng/mL. Axial T2-weighted image (TR/TE, 4,400/103; echo-train length 8)
shows low-intensity area (arrows) in inner gland at right.
|
|
View larger version (144K):
[in a new window]
|
Fig. 8B —70-year-old man with stage T2b cancer. Prostate-specific antigen is
5.9 ng/mL. Postcontrast T1-weighted image with fat suppression (550/12) shows
no enhancement with clear margin interpreted as benign prostatic hyperplasia
nodule (arrows).
|
|
View larger version (148K):
[in a new window]
|
Fig. 8C —70-year-old man with stage T2b cancer. Prostate-specific antigen is
5.9 ng/mL. Histopathologic specimen at level of lesion shows
pseudohyperplastic adenocarcinoma present at right inner gland
(arrowheads) (original magnification, H and E stain).
|
|
View larger version (170K):
[in a new window]
|
Fig. 9A —73-year-old man with stage T2b cancer. Prostate-specific antigen is
13 ng/mL. Axial T2-weighted MR image (TR/TE, 4,467/120; echo-train length, 8)
shows two hypointense areas in inner gland (arrows and
arrowheads).
|
|
View larger version (142K):
[in a new window]
|
Fig. 9B —73-year-old man with stage T2b cancer. Prostate-specific antigen is
13 ng/mL. Contrast-enhanced T1-weighted image (TR/TE, 517/13) with fat
suppression and anterior lesion shows homogeneous enhancement with irregular
margin (arrows). Posterior lesion shows no enhancement with regular
margin (arrowheads).
|
|
View larger version (145K):
[in a new window]
|
Fig. 9C —73-year-old man with stage T2b cancer. Prostate-specific antigen is
13 ng/mL. Histopathologic section shows well-differentiated adenocarcinoma in
anterior (arrows) and nodule benign prostatic hyperplasia surrounded
by capsule in posterior (arrowheads) (original magnification, H and E
stain).
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2006 by the American Roentgen Ray Society.
