Jeffrey Quon MD, Abstract Co-Author: Nothing to Disclose

Trevor A. Flood MD, FRCPC, Abstract Co-Author: Nothing to Disclose

Nicola Schieda MD, Presenter: Nothing to Disclose

After viewing this exhibit, the viewer will: a) appreciate common causes of false positive diagnoses at mp-MRI of the prostate and their histologic correlates, and b) understand helpful imaging features to avoid these pitfalls of interpretation in active surveillance patients and those with negative biopsies and rising PSA.

1. Review normal anatomic structures that can mimic prostate cancer at mp-MRI including the “central zone” and the anterior fibromuscular stroma. 2. Briefly review the concept of mp-MRI and recently proposed MR scoring systems, discussing the importance of diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE). 3. Demonstrate how DCE is a source of false positive diagnoses in glandular benign prostatic hyperplasia (BPH). Illustrate the importance of T2W and DWI for evaluation of glandular BPH. 4. Discuss the concept of “T2 blackhole effect” on DWI and how low T2 signal intensity structures can mimic tumor on apparent diffusion coefficient (ADC) map and the importance of the trace echo-planar images. 5. Demonstrate examples of stromal BPH mimicking cancer and helpful differentiating features at mp-MRI. 6. Demonstrate examples of both acute (bacterial and granulomatous) and chronic prostatitis mimicking cancer at mp-MRI.  

http://abstract.rsna.org/uploads/2014/14002534/14002534_g87i.pdf

Quon, J, Flood, T, Schieda, N, All that Glitters Is Not Gold: Multi-parametric (mp) MRI – Pathologic Correlation in False Positive Cases of Prostate Cancer Diagnosed in the Setting of Active Surveillance and Rising PSA with Negative Biopsy.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002534.html