The role of multiparametric magnetic resonance imaging in the diagnosis of granulomatous prostatitis mimicking prostate cancer.
Abdom Radiol (NY)
; 49(7): 2305-2310, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-38652127
ABSTRACT
PURPOSE:
Aimed to investigate the role of multiparametric magnetic resonance imaging (mp-MRI) in the diagnosis of granulomatous prostatitis caused by intravesical Bacillus Calmette-Guérin (BCG).METHODS:
In this prospective, single-center study, 10 male patients who were given intravesical BCG due to intermediate- and high-risk bladder cancer were included. Before transurethral resection of bladder tumors (TURB), all patients were evaluated by mp-MRI, serum prostate-specific antigen (PSA), and digital rectal examination (DRE). Serum PSA levels and DRE findings were evaluated before and after intravesical BCG treatment. Prostate mp-MRI was performed for patients with elevated levels of serum PSA and/or with abnormal DRE findings. Then, MRI fusion + systematic prostate biopsy was performed. Demographic data of the patients before and after intravesical BCG were compared.RESULTS:
The average age of the patients was 66.9 years (55-87 years). While PSA was 1.7 ng/ml before intravesical BCG treatment, it was 4.3 ng/ml after intravesical BCG treatment (p = 0.005). PSA density (PSAD) was 0.04 and 0.10 before and after the treatment, respectively (p = 0.012). DRE findings of all patients were normal before the treatment. However, abnormal findings were detected in 80% of them after the treatment (p = 0.008). PI-RADS ≥ 3 lesions were found to be significantly higher in all patients after intravesical BCG (p = 0.004).CONCLUSION:
Granulomatous prostatitis is a rare complication of intravesical BCG. High PSA, abnormal DRE, and PI-RADS ≥ 3 lesions detected after intravesical BCG should suggest granulomatous prostatitis and unnecessary biopsies may be avoided.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatitis
/
BCG Vaccine
/
Multiparametric Magnetic Resonance Imaging
/
Granuloma
Limits:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Abdom Radiol (NY)
Year:
2024
Document type:
Article
Affiliation country:
Turkey
Country of publication:
United States