Adilson Prando MD, Presenter: Nothing to Disclose

Athanase Billis MD, Abstract Co-Author: Nothing to Disclose

Histologically focal prostatic atrophy(FPA)is one of the most frequent mimics of prostatic cancer.Our purpose is to show that FPA may also simulate prostate cancer on transrectal ultrasound studies(TRUS) and on 3D-magnetic resonance spectroscopic imaging of the prostate(3D-MRSI)

From 2004 to 2006, 625 men suspected to have prostate cancer ,underwent TRUS-guided biopsy(n=513) or TRUS-guided biopsy directed with 3D-MRSI of the prostate(n=142).The latter group included only patients with elevated PSA levels and prior negative biopsies.All sites showing FPA on histopathologic analysis were correlated with findings observed on gray-scale and color Doppler TRUS studies or on 3D-MRSI of the prostate

From a total of 625 patients biopsied and studied by gray scale and color Doppler TRUS ,48 patients(7.7%), had suspicious lesions at the peripheral zone (56 hypoechoic nodules with absent flow and 18 hypoechoic nodules with increased flow).From a total of 112 patients submitted to TRUS-guided biopsy directed with 3D-MRSI,16(11.2%)showed metabolic abnormalities on the peripheral zone, strongly suggestive of prostate cancer(obvious elevation of choline-plus-creatine-to-citrate ratio).In all these patients,FPA was the only histological diagnosis. Adenocarcinoma,high-grade intraepithelial neoplasia or other atypical lesions were absent in all patients. At least one core of prostatic biopsy presenting FPA without any sonographic or MR spectroscopic imaging abnormalities was found in 128 out of the 625 patients (20.5%).

Similarly to the histopathologic findings,focal prostatic atrophy may mimic cancer on imaging studies.Radiologist should be aware of this entity which represents an important cause of false-positive result on 3D-MRSI of the prostate

Focal prostatic atrophy may simulate prostate cancer on gray-scale and color Doppler transrectal ultrasound studies and also on 3D-MRSI of the prostate

Prando, A, Billis, A, Focal Prostatic Atrophy Mimicking Prostatic Cancer: An Entity Not Known by the Radiologist.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004033.html