Prostate Cancer: Diagnosis and evaluation: Difference between revisions

← Older edit Newer edit →

VisualWikitext

@@ Line 133: / Line 133: @@
 ** Captures the movement of protons in the xy-axis (transverse)
 ** '''Primary means of visualization of zonal and anatomical features of the prostate.'''
+***See [https://www.researchgate.net/figure/Zonal-prostate-anatomy-on-axial-T2-weighted-MRI-image-peripheral-zone-PZ-and_fig1_346570342 Figure]
 ** '''<span style="color:#ff0000">Optimal sequence to evaluate lesions in the transition zone[https://pubmed.ncbi.nlm.nih.gov/31392526/]</span>'''
-** '''Due to its high water content, the peripheral zone normally displays high signal intensity. By contrast, <span style="color:#ff0000">prostate cancer has low signal intensity on T2</span> allowing for identification of suspicious lesions'''
+** '''High signal intensity'''
-*** As 70% of all prostate cancers occur within the peripheral zone, the tissue characteristics allow for T2WI to detect a significant number of tumors in this zone
+***'''Normal peripheral zone (due to its high water content)'''
-*** '''Various conditions such as prostatitis, hemorrhage, atrophy, scars and post-treatment changes have low signal intensity on T2 and can mimic cancer on T2WI.'''
+***'''Seminal vesicles'''
-**** Post-biopsy hemorrhage can interfere with tumor detection, since areas of hemorrhage appear similar to tumor on T2WI. For this reason, it is recommended to wait an interval of at least 6-8 weeks after prostate biopsy for resolution of hemorrhage or hematoma before performing prostate MRI.
+**'''Intermediate intensity'''
-** '''Low signal intensity tumors on T2WI of the central gland are more difficult to distinguish from the similarly hypointense stromal hyperplasia, ie benign prostatic hyperplasia'''
+***'''Central zone'''
-** Central zone also displays intermediate signal intensity while seminal vesicles display high signal intensity
+**'''Low signal intensity'''
+***'''Prostate cancer'''
+****As 70% of all prostate cancers occur within the peripheral zone, the tissue characteristics allow for T2WI to detect a significant number of tumors in this zone
+***'''Prostatitis'''
+***'''Hemorrhage'''
+****Post-biopsy hemorrhage can interfere with tumor detection, since areas of hemorrhage appear similar to tumor on T2WI. For this reason, it is '''recommended to wait an interval of at least 6-8 weeks after prostate biopsy for resolution of hemorrhage or hematoma before performing prostate MRI.'''
+***'''Atrophy'''
+***'''Scars'''
+***'''Post-treatment changes'''
+***'''Stromal hyperplasia i.e. benign prostatic hyperplasia'''
+****'''Clinical implication: Benign prostatic hyperplasia nodules can be difficult to distinguish from low signal intensity tumours'''
 * '''<span style="color:#ff0000">Diffusion weighted imaging (DWI)</span>'''
 ** Measures the diffusion of water protons within tissue
 ** '''<span style="color:#ff0000">Optimal sequence to evaluate lesions in the peripheral zone[https://pubmed.ncbi.nlm.nih.gov/31392526/]</span>'''
-**The images are acquired by sequentially applying multiple magnetic field gradients, known as b-values, to calculate apparent diffusion coefficient values and construct ADC maps. The higher the b-value, the stronger the diffusion effects
+**Images are acquired by sequentially applying multiple magnetic field gradients, known as b-values, to calculate ADC values and construct ADC maps. The higher the b-value, the stronger the diffusion effects
 ** '''ADC values are calculated by the software and displayed as a parametric map reflecting the degree of diffusion of water molecules through different tissues.'''
 *** Protons are mobile in normal water-rich glandular tissue but have restricted movement in densely packed water-poor tissue such as that found in tumors.
@@ Line 496: / Line 507: @@
 ## Peripheral zone
 # Describe the PROMIS and PRECISION trials
+#What is the differential diagnosis for an area of low signal intensity on T2WI?
 == Answers ==
+*What is the optimal MRI sequence to evaluate
+*# Hemorrhage
+*# Transition zone
+*# Vascularity of the prostate
+*# Peripheral zone
+* Describe the PROMIS and PRECISION trials
+*What is the differential diagnosis for an area of low signal intensity on T2WI?
 == Next Chapter: [[Prostate Cancer: PSA and Other Markers|PSA and Other Markers]] ==