UCLA: MRI Not a Reliable Method for Tumor Size Estimation in Prostate Cancer

What is Prostate Cancer?

Prostate cancer is one of the most common cancers in men and is the second leading cause of death in men in the United States. It is the cancer of the prostate gland, which is a walnut-shaped gland important for the production of seminal fluid. Prostate cancer is often asymptomatic but may manifest in the advanced stages as erectile dysfunction, blood-tinged semen, and problems with urination.

Prostate

Prostate

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One of the most important risk factors for prostate cancer is age. Men over the age of 40 years are recommended to undergo annual screenings for prostate cancer. Some of the other risk factors include obesity, family history, and race.

An early diagnosis of prostate cancer that has not spread to other parts of the body and is still local or regional is very important for a good prognosis. Prostate cancer in the early phases can be treated with minimal treatment and has a 5-year survival rate of almost 100 percent. However, if the prostate cancer has spread to other parts of the body, the 5-year survival rate drops significantly to 31 percent.

Read Also: Metastatic Prostate Cancer: New Treatment Options

After an abnormality is found in the screening tests like digital rectal exam and PSA test, diagnostic testing is done using imaging techniques like ultrasound and MRI, and these modalities also help determine the treatment plan.

However, a recent study has found that MRI frequently underestimates the size of the tumor in prostate cancer, which can be a serious issue when it comes to selecting treatment options.

A UCLA Study

A recent single-arm cohort study published in the Journal of Urology by Pooli and her team from the Department of Urology at the University of California-Los Angeles was performed to evaluate the difference or similarity between the radiologic tumor size and pathologic tumor size.

Method of the Study

For this study, the researchers studied 461 lesions in 441 men who had been diagnosed with prostate cancer, using a biopsy, and their tumor size was measured using a multiparametric MRI. All of these subjects had then undergone radical prostatectomy, after which, the tumor size was measured in the histopathology lab. The radiological and pathological tumor sizes were then compared to assess the accuracy of radiological sizing.

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Results of the Study

Pooli and her team found that the mean average radiological and pathological tumor size was 1.57cm and 2.37 cm respectively. The researchers realized that the difference between the mean averages was quite significant and concluded that multiparametric MRI consistently underestimates the size of the tumor.

This conclusion is of great importance as treatment plans and prognosis are often determined by radiological tumor size. Another issue with underestimation of tumor size is that there may be some tumor cells left behind after tumor ablation. To overcome the problem, researchers recommend a bigger ablation window to be considered.

Read Also: Treating Swollen Prostates With Steam

References

Predicting Pathological Tumor Size in Prostate Cancer Based on Multiparametric Prostate Magnetic Resonance Imaging and Preoperative Findings

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