The efficacy of multiparametric prostate MRI in making treatment decisions and predicting early recurrence in localized prostate cancer


Keven A., Gürbüz A. F., Elasan S.

Ege Tıp Dergisi, cilt.64, ss.107-117, 2025 (Hakemli Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 64
  • Basım Tarihi: 2025
  • Doi Numarası: 10.19161/etd.1556719
  • Dergi Adı: Ege Tıp Dergisi
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.107-117
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Aim: This study investigates the potential role of multiparametric magnetic resonance imaging (mpMRI) in localized prostate cancer, its impact on treatment decision-making and its predictability of the likelihood of cancer recurrence after treatment.

Material and Method: The relationships between ISUP grade groups, prostate volume, prostatespecific antigen (PSA), and free PSA values that determine the risk classification of 114 cases diagnosed with localized prostate cancer, mp-MRI findings, including index lesion diameter, apparent diffusion coefficient (ADC) value, capsule contact length, extracapsular extension, and presence of seminal vesicle invasion, and biochemical recurrence, were investigated.

Results: Of the 114 patients included in the study, 49 underwent radiotherapy and 61 underwent radical prostatectomy as curative treatments. Four patients were enrolled in an active surveillance protocol to delay potential side effects. PSA or local recurrence occurred in 13 (11.4%) patients during the follow-up period. There was a significant correlation between stable disease and absence of extracapsular invasion (p=0.022) and ISUP grade (p=0.025). There was also a significant correlation between index lesion diameter (p=0.005), capsule contact length (p=0.015), and recurrence. Additionally, the ADC value decreased as the ISUP grade and clinical stage increased (p=0.001).

Conclusion: This study's findings indicate that mp-MRI can be used for risk stratification and making risk-based treatment decisions in localized prostate cancer patients.