The visibility of prostate cancer concerning underlying histopathological variances: A single-center multiparametric magnetic resonance imaging study

Purpose: To investigate whether prostate cancer (PCa) lesions regarding histopathological composition exhibit different morphological features on multiparametric prostate MRI (mpMRI). Methods: We investigated men with PCa with available mpMRI and whole-mount specimens between June 2015 to December 2020.The acquisition protocol consistent with the Prostate Imaging Reporting and Data System (PIRADS). Two observers evaluated the images following the PI-RADS v2.1. guideline before biopsy and radical prostatectomy. The discrepancies were resolved in a joint meeting. A genitourinary pathologist reviewed the whole-digitalized mount specimens, and the lesions with Gleason score of 7 and above (3 + 4 and above), and/or cancers with a maximum diameter of 6 mm and more, and/or extraprostatic extension were accepted as clinically significant PCa. The PI-RADS scores and the diameter of the clinically significant PCa on mpMRI concerning histopathological components (i.e., cribriform component, intraductal pattern, or without cribriform component or intraductal pattern) were investigated. The clinically significant PCa foci with PI-RADS score <3 was accepted as an invisible lesion on mpMRI. Results: In all, 58 men with a total of 112 clinically significant PCa foci, were enrolled in the study. The intraductal pattern, cribriform pattern, or none of these patterns were observed in 28/112 (25 %), 43/112 (38.05 %), and 41/112 (36.60 %) tumor foci. Six out of 28 (21.42 %), 17/43 (39.53 %), and 18/41 (42.8 %) foci with an intraductal pattern, cribriform component, or without any of them, respectively, were invisible on mpMRI (P = 0.111). Conclusion: Though it was not reached a statistical significance, clinically significant PCa with the cribriform component and without any intraductal or cribriform component are more likely to manifests mpMRI invisible foci than the intraductal pattern. Further multi-center studies are warranted to precisely elucidate mpMRI features of PCa regarding histopathological composition.