Dynamic contrast-enhanced MRI of anterior prostate cancer: morphometric assessment and correlation with radical prostatectomy findings

The purpose of the study was to relate morphometric features of prostate cancers in the anterior compartment of the prostate by dynamic contrast-enhanced (DCE) MRI to subsequent histopathologic findings. We prospectively performed DCE-MRI before biopsy in patients with suspected prostate cancer and selected those showing both a suspicious lesion at MRI and positive biopsies in the anterior compartment of the gland. Tumor contours, margins, largest surface areas and volumes were assessed at MRI and histopathology, when available. Anterior compartment tumors were classified according to transition zone (TZ) boundaries with the peripheral zone (PZ) or with the anterior fibromuscular stroma (SFMA). Forty-three patients were included in this study [median PSA 12.7 ng/ml (3.6–72)]. Whole-mount radical prostatectomy specimens were available in 27 cases. Of the anterior cancers, 89% had ill-defined margins at T2-weighted MRI. Cancer location and contour established at MRI agreed well with histopathology in the 27 cases. Median largest surface area and volume were 1.38 cm² (0.35–5.82) and 1.01 cc (0.15–7.4) for MRI versus 1.86 cm² (0.2–14) and 2.84 cc (0.33–28.92) for histopathology with respective correlation coefficients (r²) of 0.73 and 0.69. The site of origin could be accurately determined for the 15 tumors of less than 3 cc. We found a good relationship between DCE-MRI and histopathology for localization, morphologic description and volume assessment of anterior prostate cancers.