BACKGROUND We investigated whether the detectability of prostate cancer with 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) differs by tumor location. METHODS We identified 136 patients with prostate cancer who underwent 3-T mpMRI before prostatectomy at a single academic center. Two uroradiologists scored all MRIs with Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2). A genitourinary pathologist mapped tumor foci from serial whole-mount radical prostatectomy sections. We assessed concordance of images with cancer sites. Tumor foci with Gleason score ≥  3 + 4 or volume ≥ 0.5 mL were considered significant. RESULTS A total of 122 foci in 106 cases were identified with mpMRI. Twenty-four were PI-RADS 3, 52 were 4, and 46 were 5. A total of 274 tumor foci were identified with whole-mount pathology. The sensitivity stratified by location to detect significant cancer with a PI-RADS cutoff value of 3 was 56.0% overall, 50.0% in the peripheral zone (PZ), 71.2% in the transitional zone (TZ), 62.4% anterior, 49.5% posterior, 42.0% apical, 63.6% in the midgland, and 43.8% in the gland base. In multivariate analysis, tumor location was not a significant predictor of identification by mpMRI. Tumor volume, Gleason score, and index tumor status were significantly associated with identification by mpMRI. CONCLUSIONS mpMRI detected the majority of high-grade and large cancers, but had low sensitivity in the PZ, posterior, and apex and base of the gland. The high prevalence of low-volume, low-Gleason score index tumors, as well as satellite tumors in those areas, accounted for the difference.

中文翻译：

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3-Tesla多参数磁共振成像可检测腺体不同部位的前列腺癌：与整个组织病理学的关系。

背景我们研究了3-Tesla（3T）多参数磁共振成像（mpMRI）对前列腺癌的可检测性是否因肿瘤位置而异。方法我们确定了136例前列腺癌患者，他们在一个学术中心进行了前列腺切除术前的3-T mpMRI。两名泌尿外科放射科医生对所有MRI的前列腺成像报告和数据系统版本2（PI-RADS v2）进行了评分。泌尿生殖系统病理学家从连续的全根治性前列腺切除术切片中标出了肿瘤灶。我们评估了图像与癌症部位的一致性。格里森评分≥3 + 4或体积≥0.5 mL的肿瘤灶被认为是重要的。结果经mpMRI检出106例患者共122个病灶。PI-RADS 3共有24个，PI-RADS 3有52个，PI-RADS 3有46个。在整个安装病理中，共鉴定出274个肿瘤灶。按位置分层的，可检测出PI-RADS临界值为3的重大癌症的总体敏感性为56.0％，外围区域（PZ）为50.0％，过渡区域（TZ）为71.2％，前部为62.4％，后部为49.5％ ，根尖42.0％，中部腺体63.6％，腺体基部43.8％。在多变量分析中，肿瘤位置不是通过mpMRI识别的重要预测指标。肿瘤体积，格里森评分和指标肿瘤状态与mpMRI鉴定显着相关。结论mpMRI可检测到大多数高级别和大型癌症，但对PZ，后部，根尖和腺体的敏感性较低。造成这种差异的原因是小体积，低格里森评分指数肿瘤以及卫星肿瘤在这些地区的高患病率。