PROGNOSTIC SIGNIFICANCE OF MAGNETIC RESONANCE IMAGING IN PATIENTS WITH PROSTATE INTRAEPITHELIAL NEOPLASIA

Abstract

The aim: To determine prognostic significance of mpMRI in prostate intraepithelial neoplasia (PIN) diagnostics. Materials and methods: The results of examination of 52 patients with PIN were assessed in mpMRI using PIRADS criteria. The total number of samples with PIN amounted 166. According to PIRADS MRI assessment of central and peripherial zones was made separately. The use of T2WI, DWI, DCE in patients with high grade and low grade PIN was studied. MRI was performed before prostate biopsy (MRI cognitive fusion biopsy). During 3-year follow-up rebiopsies were performed with prostate cancer detection. PIRADS values of PIN lesions with malignisation were compared with those without following tumor transformation. Results: There was a difference in values of PIRADS characteristics between PIN and benign prostatic tissue. The mean of PIRADS gradation in samples with PIN was 2,1. Among them 47 (28,3 %) PIN samples had gradation 3 (the presence of clinically significant cancer is equivocal), in 8 (4,8 %) cases – gradation 4 (clinically significant cancer is likely to be present). The mean of PIRADS gradation was in 24 % larger in cases with subsequent PC detection than in cases without malignisation. Conclusions: MRI parameters in PIN cases differ from normal prostate tissue. PIRADS assessment has prognostic significance of following malignisation of PIN pieces that have similar properties on MRI as prostate cancer. Further study is required to stratify all PIN patients into groups of high malignisation risk in order to perform detailed examination and treatment.