ROLE OF MAGNETIC RESONANCE IMAGING IN ASSESSING CAVERNOSAL AND URETHRAL INVASION OF PENILE CANCER

Lịnh Bảo Nguyên Đỗ, Chí Phong Nguyễn, Phương Thảo Nghiêm

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Abstract

Objective: Describing the MRI imaging characteristics in T staging and assess the role of MRI in cavernosal and urethral invasion of penile cancer (PC). Subjects and Methods: A retrospective cross-sectional study was conducted on 60 PC patients who underwent preoperative MRI with diffusion-weighted sequences. Diagnosis was confirmed by pathological results from postoperative specimens at Binh Dan Hospital from 01/01/2022 to 31/05/2024. MRI imaging features were evaluated preoperatively and compared with histopathological findings. Results: The study included 60 PC cases. The average age of the study group was 55.78 ± 14.37 years, with the most common age group being 41-60 years, accounting for 58% of cases. Most patients had no history of childhood circumcision (56.7%). The majority presented with penile lesions (95%), primarily as exophytic growths (58.3%). The most common site was the glans, observed in more than half of the cases (around 53.3%). The average tumor size was 37.82 ± 16.73 (mm). Histopathology revealed that 98% were squamous cell carcinoma, with most being moderately to well-differentiated lesions (93%). On MRI, most tumors exhibited low signals on T1W (93.3%) and T2W (78.3%). Nearly half of the cases had necrotic tumors (48.3%) and displayed poor enhancement with contrast (45%). A significant proportion of tumors exhibited restricted diffusion (83.3%). There was a statistically significant correlation between ADC values and tumor differentiation on histopathology (p < 0.05), with ADC values decreasing as tumor differentiation worsened. The sensitivity, specificity, and accuracy of MRI for assessing cavernosal invasion were 94.4%, 87.5%, and 91.7%, respectively, and for urethral invasion were 94.1%, 83.7%, and 88.7%. Conclusion: MRI is an effective imaging modality for evaluating cavernosal and urethral invasion, assisting in determining appropriate surgical treatment for patients.

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References

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