MRI May Help Select PCa Patients for Active Surveillance - Presentation by Hebert Alberto Vargas, MD

  • Slide 1

    Slide 1

    Normal zonal anatomy. Axial (Slide 1) and coronal (Slide 2) T2-weighted images of the prostate demonstrate the normal peripheral zone (straight arrows) with homogenous high signal intensity the transition zone (asterisk) with heterogeneous signal intensity owing to variable amounts of glandular and fibrous stroma, and the low signal intensity central zone (curved arrows) which surrounds the ejaculatory ducts.

  • Slide 2

    Slide 2

    Normal zonal anatomy. Axial (Slide 1) and coronal (Slide 2) T2-weighted images of the prostate demonstrate the normal peripheral zone (straight arrows) with homogenous high signal intensity the transition zone (asterisk) with heterogeneous signal intensity owing to variable amounts of glandular and fibrous stroma, and the low signal intensity central zone (curved arrows) which surrounds the ejaculatory ducts.

  • Slide 3

    Slide 3

    Axial T2-weighted image of the prostate demonstrates a focal T2-hypointense tumor (arrow) in the left posterolateral peripheral zone.

  • Slide 4

    Slide 4

    Axial T2-weighted images of 2 different patients demonstrate focal T2 hypointense tumors in the anterior prostate (arrows). Anterior prostate tumors are sometimes difficult to detect on transrectal biopsies, and patients typically present with rising PSA despite negative prostate biopsies.

  • Slide 5

    Slide 5

    Axial T2-weighted images of 2 different patients demonstrate focal T2 hypointense tumors in the anterior prostate (arrows). Anterior prostate tumors are sometimes difficult to detect on transrectal biopsies, and patients typically present with rising PSA despite negative prostate biopsies.

  • Slide 6

    Slide 6

    Indeterminate findings on MRI. Axial (Slide 6) and coronal (Slide 7) T2-weighted images demonstrate heterogeneous signal intensity throughout the peripheral zone. In some cases this may be due to post-biopsy artifact, and it limits the detection of tumors on MRI.

  • Slide 7

    Slide 7

    In some cases this may be due to post-biopsy artifact, and it limits the detection of tumors on MRI.

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Hebert Alberto Vargas, MD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York studied 388 consecutive PCa patients who had a PSA level below 10 ng/mL, a clinical stage T2a or less, and a Gleason score of 6 or less. All underwent endorectal MRI prior to confirmatory biopsy.

What follows is a series of MRI scans provided by Dr. Vargas that serve as examples of what the scans can reveal about prostate tumors.

Click here to read the full article.

Images provided courtesy of Hebert Alberto Vargas, MD, of Memorial Sloan-Kettering Cancer Center in New York.

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