PMID- 34038039 OWN - NLM STAT- MEDLINE DCOM- 20220414 LR - 20220414 IS - 1464-410X (Electronic) IS - 1464-4096 (Linking) VI - 129 IP - 2 DP - 2022 Feb TI - Multiparametric magnetic resonance imaging of the prostate underestimates tumour volume of small visible lesions. PG - 201-207 LID - 10.1111/bju.15498 [doi] AB - OBJECTIVE: To assess the relationship between the volume of the index lesion (IL) measured at multiparametric magnetic resonance imaging (mpMRI; MRIvol) and at radical prostatectomy (RPvol), stratifying it according to Prostate Imaging-Reporting and Data System (PI-RADS) score. PATIENTS AND METHODS: We identified 332 men with a positive mpMRI (single lesion with PI-RADS >/=3) who underwent systematic plus targeted biopsy and subsequent RP at two tertiary referral centres between 2013 and 2018. All mpMRIs were reviewed by experienced radiologists using PI-RADS scores. The study outcome was to assess the relationship between MRIvol (based on planimetry from MRI sequence best showing tumour) and RPvol (based on tumour involved area of each RP pathology slice). To achieve this endpoint, we performed a multivariable linear regression analysis (LRA) to predict RPvol using PI-RADS, prostate-specific antigen level, prostate volume, age, digital rectal examination, Gleason score at MRI-targeted biopsy, biopsy history and time from mpMRI to RP as covariates. Non-parametric locally estimated scatterplot smoothing (LOESS) function was used to graphically explore the relationship between MRIvol and RPvol, stratifying for PI-RADS score. RESULTS: Overall, 24%, 49% and 27% of men had visible PI-RADS 3, 4 and 5 lesions at mpMRI. The median (interquartile range [IQR]) MRIvol and RPvol were 0.67 (0.29-1.76) mL and 1.39 (0.58-4.23) mL. At LRA, MRIvol was significantly correlated with a RPvol underestimation (slope: 2.4, 95% confidence interval [CI] 0.1-46.3). The non-parametric LOESS analysis showed a non-linear relationship between MRIvol and RPvol. Significant underestimation was reported across all volumes with the highest differences between MRIvol and RPvol in the low volume range (<2 mL), where RPvol almost doubled MRIvol. A similar effect was observed across all PI-RADS scores subgroups. CONCLUSIONS: In the present study, mpMRI significantly underestimated the exact volume of the IL, especially for small visible lesions, regardless of PI-RADS score. This should be considered when planning tailored focal therapy approaches often delivered to men with smaller prostatic lesions. CI - (c) 2021 The Authors BJU International (c) 2021 BJU International. FAU - Sorce, Gabriele AU - Sorce G AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Stabile, Armando AU - Stabile A AUID- ORCID: 0000-0002-3700-0069 AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Luciano, Roberta AU - Luciano R AD - Department of Pathology, San Raffaele Hospital, San Raffaele University, Milan, Italy. FAU - Motterle, Giovanni AU - Motterle G AD - Department of Urology, Mayo Clinic, Rochester, MN, USA. FAU - Scuderi, Simone AU - Scuderi S AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Barletta, Francesco AU - Barletta F AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Pellegrino, Francesco AU - Pellegrino F AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Cucchiara, Vito AU - Cucchiara V AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Gandaglia, Giorgio AU - Gandaglia G AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Fossati, Nicola AU - Fossati N AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - De Cobelli, Francesco AU - De Cobelli F AD - Department of Radiology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Montorsi, Francesco AU - Montorsi F AUID- ORCID: 0000-0002-7267-4181 AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. FAU - Jeffrey Karnes, R AU - Jeffrey Karnes R AD - Department of Urology, Mayo Clinic, Rochester, MN, USA. FAU - Guccini, Ilaria AU - Guccini I AUID- ORCID: 0000-0002-3644-0679 AD - Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland. FAU - Briganti, Alberto AU - Briganti A AD - Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. LA - eng PT - Journal Article DEP - 20210613 PL - England TA - BJU Int JT - BJU international JID - 100886721 SB - IM MH - Humans MH - Image-Guided Biopsy/methods MH - Magnetic Resonance Imaging/methods MH - Male MH - *Multiparametric Magnetic Resonance Imaging MH - Prostate/diagnostic imaging/pathology MH - *Prostatic Neoplasms/pathology MH - Retrospective Studies MH - Tumor Burden OTO - NOTNLM OT - MRI OT - biopsy OT - diagnosis OT - focal therapy OT - prostate cancer OT - targeted biopsy EDAT- 2021/05/27 06:00 MHDA- 2022/04/15 06:00 CRDT- 2021/05/26 12:49 PHST- 2021/05/01 00:00 [revised] PHST- 2020/09/20 00:00 [received] PHST- 2021/05/23 00:00 [accepted] PHST- 2021/05/27 06:00 [pubmed] PHST- 2022/04/15 06:00 [medline] PHST- 2021/05/26 12:49 [entrez] AID - 10.1111/bju.15498 [doi] PST - ppublish SO - BJU Int. 2022 Feb;129(2):201-207. doi: 10.1111/bju.15498. Epub 2021 Jun 13.