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3T mpMRI Helps Detect High-Grade Cancers

Key clinical point: 3-Test multiparametric magnetic resonance imaging (3-T mpMRI) “detected the majority of high-grade and large cancers, but had low sensitivity in the PZ [peripheral zone], posterior, and apex and base of the gland. The high prevalence of low-volume, low-Gleason score index tumors, as well as satellite tumors in those areas, accounted for the difference,” according to investigators.

Major finding: Location of the tumor was not a significant predictor of identification by mpMRI, while “tumor volume, Gleason score, and index tumor status were significantly associated,” they wrote.

Study details: The study included 136 patients undergoing 3-T mpMRI before prostatectomy at a single academic center.

Disclosures: None reported.


Ito K, et al. Int J Clin Oncol. 2019 Dec 2. doi: 10.1007/s10147-019-01587-8.


Patients with elevated prostate-specific antigen (PSA) levels often have biopsies performed on both lobes of the prostate. More precise imaging could lead to improved biopsy guidance and staging. Ito et al. evaluated whether the use of 3 Tesla MRI (3T-MRI) could aid in identifying loci of cancer in different regions of the prostate. The sensitivity for the diagnosis of significant cancers was 56% for all loci, with variation in sensitivity ranging from 42% in the apex to 71.2% in the transitional zone. Increased tumor volume and higher Gleason scores were associated with cancer detection via 3T-MRI. Overall, the results suggest a use for 3T-MRI in detecting higher grade and larger tumors. This modality is not ideal for detection of lower grade and smaller tumors, nor for more focused needle guidance of biopsies.—Mark A. Klein, MD