Multiparametric MRI characteristics of prostatitis and atrophy in the peripheral zone in men without prostate cancer

• Published in: European journal of radiology 2023-12, Vol.169, p.111151-111151, Article 111151
• Main Authors: Al-Monajjed, R., Radtke, JP, Thomas, M., Boschheidgen, M., Drewes, LR, Ullrich, T, Rau, T., Esposito, I., Antoch, G., Albers, P., Lopez-Cotarelo, C., Schimmöller, L.
• Format: Article
• Language: English
• Subjects: Atrophy; Humans; Image-Guided Biopsy - methods; Magnetic Resonance Imaging - methods; Male; Multiparametric Magnetic Resonance Imaging; Multiparametric MRI; Non-neoplastic conditions of the prostate; Prostate biopsy; Prostate-Specific Antigen; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Prostatitis; Prostatitis - diagnostic imaging; Retrospective Studies
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2023.111151

•Characteristics of prostatitis on MRI can be T2w hypointensity and DCE enhancement, but they seem not specific and/or correlated to the histopathologic quantity of prostatitis.•Presence of atrophy and/or prostatitis is frequent and was increased with higher PI-RADS classifications. Thus, knowledge about the influence on PI-RADS scores seems essential to avoid false positive cases.•Based on our subcohort younger men tend to have lower incidence of prostatitis and atrophy, yet can exhibit likely age-related T2w hypointensity and DCE enhancement. To analyse multiparametric magnetic resonance imaging (mpMRI) characteristics and appearance of histopathologically proven non-cancerous intraprostatic findings focussing on quantity of prostatitis and atrophy in the peripheral zone. In this retrospective analysis consecutive patients with mpMRI followed by MRI/TRUS-fusion biopsy comprising targeted (TB) and systematic biopsy (SB) cores without prostate cancer (PC) at histopathology were included. Subgroup analysis was performed in younger men (≤50 years). The proportions of prostatitis and atrophy were quantified for each biopsy core based on histopathology. MRI findings in the peripheral zone (PZ) and index lesions (IL, most suspicious/representative lesion) were characterized regarding changes in T2w, ADC value, and enhancement of dynamic contrast enhancement (DCE) and correlated with quantity of prostatitis and atrophy. Seventy-two patients were analysed. The median baseline characteristics were PSA 5.4 ng/ml (4.0–7.9), PI-RADS classification 3 (2–4), prostate volume 43 ml (33–57), and PSA density 0.13 ng/ml2 (0.10–0.19). Prostatitis was found in 44 % (n = 32) and atrophy in 65 % (n = 47) of cases. The quantity of atrophy demonstrated a significant correlation to T2w changes, ADC increase and DCE enhancement (p = 0.05, p = 0.05, p = 0.01), whereas quantity of prostatitis did not show any significant correlation to the MRI changes (p = 0.68, p = 0.58, p = 0.95). Quantity of prostatitis and atrophy increased with PI-RADS classification. Younger men had lower PSA (4.4 vs. 7.8 ml/ng; p