# Discrepancy in the Location of Prostate Cancer Indicated on Biparametric Magnetic Resonance Imaging and Pathologically Diagnosed Using Surgical Specimens

## TL;DR

This study compares where prostate cancer appears on MRI scans versus where it is found in surgical samples, finding discrepancies in detection accuracy depending on cancer location.

## Contribution

The study highlights the limitations of biparametric MRI in detecting prostate cancer at the base of the prostate, despite high accuracy in other regions.

## Key findings

- Biparametric MRI showed high accuracy for prostate cancers in the middle of the prostate (p = 0.029).
- MRI had low accuracy for prostate cancers located at the base of the prostate, all of which were clinically significant.
- No patients had missed clinically significant prostate cancer, but multiple lesions may exist even if MRI does not detect them.

## Abstract

Accurate diagnosis of the localization of prostate cancer (PCa) on magnetic resonance imaging (MRI) remains a challenge. We aimed to assess discrepancy between the location of PCa pathologically diagnosed using surgical specimens and lesions indicated as possible PCa by the Prostate Imaging Reporting and Data System on MRI. The primary endpoint was the concordance rate between the site of probable clinically significant PCa (csPCa) identified using biparametric MRI (bpMRI) and location of PCa in the surgical specimen obtained using robot-assisted total prostatectomy. Among 85 lesions identified in 30 patients; 42 (49.4%) were identified as possible PCa on MRI. The 85 PCa lesions were divided into positive and negative groups based on the bpMRI results. None of the patients had missed csPCa. Although the diagnostic accuracy of bpMRI was relatively high for PCas located in the middle of the prostate (p = 0.029), it was relatively low for PCa located at the base of the prostate, all of which were csPCas. Although current modalities can accurately diagnose PCa, the possibility that PCa is present with multiple lesions in the prostate should be considered, even if MRI does not detect PCa.