The Prostate Imaging Reporting and Data System(PI-RADS)has good ability to identify the nature of lesions on prostate magnetic resonance imaging(MRI).However,some lesions are still reported as PI-RADS 4 and 5 but are ...The Prostate Imaging Reporting and Data System(PI-RADS)has good ability to identify the nature of lesions on prostate magnetic resonance imaging(MRI).However,some lesions are still reported as PI-RADS 4 and 5 but are biopsy-proven benign.Herein,we aimed to summarize the reasons for the negative prostate biopsy of patients who were assessed as PI-RADS 4 and 5 by biparameter MRI.We retrospectively sorted out the prostate MRI,treatment,and follow-up results of patients who underwent a biparameter MRI examination of the prostate in The First Affiliated Hospital of Nanjing Medical University(Nanjing,China)from August 2019 to June 2021 with PI-RADS 4 and 5 but a negative biopsy.We focused on reviewing the MRI characteristics.A total of 467 patients underwent transperineal prostate biopsy.Among them,biopsy pathology of 93 cases were negative.After follow-up,90 patients were ruled out of prostate cancer.Among the 90 cases,40 were considered to be overestimated PI-RADS after review.A total of 22 cases were transition zone(TZ)lesions with regular appearance and clear boundaries,and 3 cases were symmetrical lesions.Among 15 cases,the TZ nodules penetrated the peripheral zone(PZ)and were mistaken for the origin of PZ.A total of 17 cases of lesions were difficult to distinguish from prostate cancer.Among them,5 cases were granulomatous inflammation(1 case of prostate tuberculosis).A total of 33 cases were ambiguous lesions,whose performance was between PI-RADS 3 and 4.In summary,the reasons for“false-positive MRI diagnosis”included PI-RADS overestimation,ambiguous images giving higher PI-RADS,diseases that were really difficult to distinguish,and missed lesion in the initial biopsy;and the first two accounted for the most.展开更多
文摘The Prostate Imaging Reporting and Data System(PI-RADS)has good ability to identify the nature of lesions on prostate magnetic resonance imaging(MRI).However,some lesions are still reported as PI-RADS 4 and 5 but are biopsy-proven benign.Herein,we aimed to summarize the reasons for the negative prostate biopsy of patients who were assessed as PI-RADS 4 and 5 by biparameter MRI.We retrospectively sorted out the prostate MRI,treatment,and follow-up results of patients who underwent a biparameter MRI examination of the prostate in The First Affiliated Hospital of Nanjing Medical University(Nanjing,China)from August 2019 to June 2021 with PI-RADS 4 and 5 but a negative biopsy.We focused on reviewing the MRI characteristics.A total of 467 patients underwent transperineal prostate biopsy.Among them,biopsy pathology of 93 cases were negative.After follow-up,90 patients were ruled out of prostate cancer.Among the 90 cases,40 were considered to be overestimated PI-RADS after review.A total of 22 cases were transition zone(TZ)lesions with regular appearance and clear boundaries,and 3 cases were symmetrical lesions.Among 15 cases,the TZ nodules penetrated the peripheral zone(PZ)and were mistaken for the origin of PZ.A total of 17 cases of lesions were difficult to distinguish from prostate cancer.Among them,5 cases were granulomatous inflammation(1 case of prostate tuberculosis).A total of 33 cases were ambiguous lesions,whose performance was between PI-RADS 3 and 4.In summary,the reasons for“false-positive MRI diagnosis”included PI-RADS overestimation,ambiguous images giving higher PI-RADS,diseases that were really difficult to distinguish,and missed lesion in the initial biopsy;and the first two accounted for the most.
