The efficacy of multiparametric prostate MRI in making treatment decisions and predicting early recurrence in localized prostate cancer

Ayse Keven; Ahmet Faruk Gürbüz; Sadi Elasan

doi:10.19161/etd.1556719

EN TR

The efficacy of multiparametric prostate MRI in making treatment decisions and predicting early recurrence in localized prostate cancer

Abstract

Aim: This study investigates the potential role of multiparametric magnetic resonance imaging (mp-MRI) in localized prostate cancer, its impact on treatment decision-making and its predictability of the likelihood of cancer recurrence after treatment. Material and Method: The relationships between ISUP grade groups, prostate volume, prostate-specific antigen (PSA), and free PSA values that determine the risk classification of 114 cases diagnosed with localized prostate cancer, mp-MRI findings, including index lesion diameter, apparent diffusion coefficient (ADC) value, capsule contact length, extracapsular extension, and presence of seminal vesicle invasion, and biochemical recurrence, were investigated. Results: Of the 114 patients included in the study, 49 underwent radiotherapy and 61 underwent radical prostatectomy as curative treatments. Four patients were enrolled in an active surveillance protocol to delay potential side effects. PSA or local recurrence occurred in 13 (11.4%) patients during the follow-up period. There was a significant correlation between stable disease and absence of extracapsular invasion (p=0.022) and ISUP grade (p=0.025). There was also a significant correlation between index lesion diameter (p=0.005), capsule contact length (p=0.015), and recurrence. Additionally, the ADC value decreased as the ISUP grade and clinical stage increased (p=0.001). Conclusion: This study's findings indicate that mp-MRI can be used for risk stratification and making risk-based treatment decisions in localized prostate cancer patients.

Keywords

Multiparametrik prostat MRI'nın lokalize prostat kanserinde tedavi seçimi ve erken nüks saptamaya etkisi

Öz

Amaç: Çalışmada amacımız, prostat kanseri tanısında, giderek kullanımı artan multiparametrik prostat MRG’nin lokalize hastalıkta tedavi kararlarındaki potansiyel rolünü ve tedavi sonrası erken dönemde nüksü belirlemede prognostik önemini araştırmaktır. Gereç ve Yöntem: Lokalize prostat kanseri tanısı alan 114 olgunun risk sınıflamasını belirleyen ISUP derecesi, prostat spesifik antijen (PSA), serbest PSA, prostat volüm ile mp-MRI incelemede indeks lezyon çapı, görünür difüzyon katsayısı (ADC) değeri, kapsül temas uzunluğu, ekstrakapsular uzanım ve seminal vezikül invazyonu varlığının biyokimyasal nüks ile ilişkisi araştırılmıştır. Gruplar arasındaki radyolojik ve klinik özelliklerin dağılımındaki farklılıklar, ki-kare testi kullanılarak istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 114 hastanın 49'una radyoterapi, 61'ine radikal prostatektomi olmak üzere küratif tedavi uygulanmıştır. Dört hasta ise yan etkileri ertelemek amacıyla aktif izlem protokolüne alınmıştır. Takipte 13 (11,4%) hastada PSA veya lokal nüks meydana gelmiştir. Nüksüz hastalık ile ekstrakapsüler invazyon yokluğu(p=0,022) ve ISUP derecesi (p=0,025) arasında istatistik olarak anlamlı bir ilişki gözlenmiştir. İndeks lezyon çapı ölçümü (p=0,005) ve kapsül temas uzunluğu ölçümü(p=0,015) ile erken dönem nüks hastalık arasında istatiksel olarak anlamlı ilişki gözlenmiş olup, ISUP derecesi arttıkça ve klinik evre arttıkça ADC değeri düşmekteydi (p=0,001). Sonuç: Bu çalışmanın bulguları, mp-MRI'nin lokalize prostat kanseri hastalarında risk sınıflandırması ve riske dayalı tedavi kararları vermek için kullanılabileceğini göstermektedir.

Anahtar Kelimeler

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol was approved by the Akdeniz University’s ethics committee (Approval Date: 24.05.2023, Approval No.424).

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Details

Primary Language

English

Subjects

Radiology and Organ Imaging

Journal Section

Research Article

Authors

Ayse Keven ^*
0000-0002-1662-8586
Türkiye

Ahmet Faruk Gürbüz
0000-0002-3912-1024
Türkiye

Sadi Elasan
0000-0002-3149-6462
Türkiye

Publication Date

March 12, 2025

Submission Date

September 26, 2024

Acceptance Date

January 1, 2025

Published in Issue

Year 2025 Volume: 64 Number: 1

DOI

https://doi.org/10.19161/etd.1556719

IZ

https://izlik.org/JA46AN76ER

Cite

RIS / Bibtex

Vancouver

1.Ayse Keven, Ahmet Faruk Gürbüz, Sadi Elasan. The efficacy of multiparametric prostate MRI in making treatment decisions and predicting early recurrence in localized prostate cancer. EJM. 2025 Mar. 1;64(1):107-1. doi:10.19161/etd.1556719