EVALUATION OF CANCER RISK OF PIRADS 5 NODULES OF THE PROSTATE TRANSITION ZONE ACCORDING TO THE PI-RADS V2.1 CLASSIFICATION ON MAGNETIC RESONANCE IMAGING COMBINED WITH DENSITY PSA

Đình Âu Hoàng 1,, Thị Thanh Trương 1
1 HMU hospital

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Abstract

Purpose: To evaluate the risk of cancer of PIRADS 5 nodules of the prostate transition zone according to the PI-RADS v2.1 classification on magnetic resonance imaging in combination with density PSA, with the results of prostate transrectal ultrasound guided biopsy as reference. Material and Methods: A retrospective descriptive study on 25 male patients at Hanoi Medical University Hospital from February 2019 to May 2022 due to high total PSA and/or urinary disorder. All patients underwent multiparameter magnetic resonance prostate imaging and transitional zone nodules classification according to PI-RADS v2.1. PIRADS 5 nodules will be biopsied under transrectal ultrasound guided then compared with histopathological results and combined with density PSA to assess the cancer risk of these nodules. Results: The mean age of the group of patients in the study was 68.2±9.1, the highest was 83 years old, the lowest was 53 years old. There are 05 patients without urinary disorders, accounting for 20%. The mean total PSA concentration in the group of patients was 46.5±33.6 ng/ml, the highest was 100 ng/ml, the lowest was 7 ng/ml. The mean prostate volume of the group of patients was 52.3±54.7 cm3, the highest was 308 cm3, the lowest was 22 cm3. The mean PSA density of the group of patients was 1.1±0.76 ng/ml/cm3, the highest was 2.63 ng/ml/cm3, the lowest was 0.09 ng/ml/cm3. There was 01 patient with PSA density < 0.10 ng/ml/cm3 and 01 patient with PSA density from 0.10-0.19 ng/ml/cm3, the rest PSA density ≥ 0.20 ng/ml/cm3. The results of prostate biopsy under transrectal ultrasound guided showed that 23/25 PIRADS 5 patients had cancer (92%, of which 02 patients GS=6; 12 patients GS=7; 06 patients GS=8 and 03 patients GS=9). The combination of PI-RADS v2.1 classification with PSA density was found in 2 patients with PIRADS 5 and PSA density <0.20 ng/ml/cm3, all of which were benign. All 23 patients with PIRADS 5 and PSA density ≥ 0.20 ng/ml/cm3 were all cancer. Conclusion: PI-RADS v2.1 classification on magnetic resonance imaging played an important role in screening for prostate cancer. For PIRADS 5 nodules of transition zone, the cancer rate is up to 92%. Combined with PSA density, with threshold ≥ 0.20ng/ml/cm3, all PIRADS 5 nodules of transition zones were cancer (accounting for 100%).

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References

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