Typically, the transition zone (TZ) is the site of benign prostatic hyperplasia (BPH), whereas peripheral zone (PZ) cancer accounts for 75–85% of all prostate cancer cases. Overtreatment of prostate cancer leads to serious complications (such as impotence and incontinence) that affect the quality of life of the patients, and it unnecessarily increases healthcare costs.Ĭurrent knowledge of the anatomic structure of the prostate is largely based on the clinically significant zonal classification of McNeal. However, despite these methods, overtreatment of prostate cancer remains an important clinical issue, and there is a need for better and personalized risk assessment at the time of diagnosis. Various methods for prostate cancer risk assessment (e.g., nomograms) have been devised that incorporate laboratory findings (e.g., serum prostate-specific antigen concentration), patient demographics (e.g., age), and clinical findings (e.g., digital rectal examination) to differentiate intermediate and high-risk patients (i.e., those who benefit from aggressive therapy such as radical prostatectomy and radiation therapy) from low-risk patients (i.e., those who benefit from active surveillance). It is estimated that one in six American men will be diagnosed with prostate cancer in their lifetime, but only a small proportion of these patients will die of the disease.
Prostate cancer is a heterogeneous disease that ranges clinically from indolent to highly aggressive. Keywords: Gleason score, MRI, prostate cancer Central gland volume fraction, PSAD, and PSAD for the central gland estimated from MRI examinations show a modest but significant correlation with Gleason score and have the potential to contribute to personalized risk assessment for significant prostate cancer. The Gleason score was significantly correlated with central gland volume fraction (ρ = −0.42 p = 0.0007), PSAD (ρ = 0.46 p = 0.0002), and PSAD for the central gland (ρ = 0.55 p = 0.00001).ĬONCLUSION. Of the 61 patients, eight (13.1%) had a Gleason score of 6, 40 (65.6%) had a Gleason score of 7, seven (11.5%) had a Gleason score of 8, and six (9.8%) had a Gleason score of 9 for prostate cancer. The estimated total prostate volume showed a high correlation with reference standard volume ( r = 0.94). These MRI-based volume and volume-adjusted PSA estimates were compared with prostatectomy specimen weight and Gleason score by using Pearson ( r) or Spearman (ρ) correlation coefficients. A semiautomated and MRI-based technique was used to estimate total and central gland prostate volumes, central gland volume fraction (central gland volume divided by total prostate volume), PSA density (PSAD PSA divided by total prostate volume), and PSAD for the central gland (PSA divided by central gland volume). The study included 61 patients with prostate cancer (average age, 63.3 years range 52–75 years) who underwent MRI before prostatectomy. The purpose of this article is to study relationships between MRI-based prostate volume and volume-adjusted serum prostate-specific antigen (PSA) concentration estimates and prostate cancer Gleason score.