Natural history of prostatic lesions on serial multiparametric magnetic resonance imaging

摘要

Introduction: The natural history of prostatic lesions identified on multiparametricmagnetic resonance imaging (mpMRI) is largely unknown. We aimed to describechanges observed over time on serial MRI.Methods: All patients with ≥2 MRI studies between 2008 and 2015 at our institutionwere identified. MRI progression was defined as an increase in Prostate ImagingReporting and Data System (PI-RADS; version 2) or size of existing lesions, or theappearance of a new lesion PIRADS ≥4. Patients on active surveillance (AS) wereanalyzed for correlation of MRI progression to biopsy reclassification.Results: A total of 83 patients (54 on AS and 29 for diagnostic purposes) underwentserial MRI, with a mean interval of 1.9 years between scans. At baseline, 115 lesions (66index, 49 non-index) were identified. Index lesions were more likely than non-indexlesions to increase in size ≥2 mm (36.2 vs. 7.3 %; p=0.002). Overall progression wasmore likely to be seen among the index cohort (34.8 vs. 7.6%; p0.001). New lesionswith PIRADS ≥4 were seen on second imaging in 13 (16.5%) men, and became the indexlesion in 29 cases (34.9%). Eighteen men on AS showed evidence of MRI progression(five with new lesions, 13 with progression of a previous lesion). Biopsy reclassificationwas present in three men (16.7%) with and seven men without MRI progression (19.4%).Conclusions: Overall changes in size and PIRADS scores of index lesions on MRI weresmall. New lesions were common, but usually did not alter management.