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Urinary Imaging

E2561. Extraprostatic Extension on Prostate mpMRI: A Pictorial Review With Histopathologic Correlation

Jobanputra K,  Diaz de Leon A,  Pedrosa I,  Roehrborn C,  Francis F,  Costa D. UT Southwestern Medical Center, Dallas, TX

Address correspondence to D. Costa (daniel.costa@utsouthwestern.edu)

Background Information: Preoperative detection of extraprostatic extension (EPE) in prostate cancer (PCa) may affect clinical management and surgical planning. This educational exhibit provides an illustrated review of the qualitative descriptors commonly used in multiparametric MRI (mpMRI), correlated with patient-specific whole-mount sectioning of prostatectomy specimens.

Educational Goals/Teaching Points: We describe the PCa local staging system; review clinical relevance of accurate pretreatment risk stratification in men with PCa; and provide an illustrated review of the qualitative imaging descriptors used for evaluation of EPE with mpMRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Multiple examples of 3T multiparametric MRI correlated with patient-specific whole-mount sections of prostatectomy specimens illustrating the following qualitative imaging findings: asymmetry or invasion of the neurovascular bundle, prostatic contour bulging, irregular or spiculated margin, obliteration of the rectoprostatic angle, tumor-capsule interface of greater than 1.0 cm, breach of the capsule with evidence of direct tumor extension or bladder wall invasion.

Conclusion: Suspicion for EPE on mpMRI may affect clinical management and surgical planning. Proper recognition and reporting of the qualitative descriptors used in mpMRI of the prostate, therefore, should facilitate informed decision-making, patient counseling and treatment planning.