Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness
ABSTRACT Purpose: The objective of this study was to evaluate whether morphological (linear measurements) and functional (ADC value) assessments of periprostatic fat can predict the aggressiveness of prostate cancer (PCa) over a 5-year follow-up period. Material and Methods: This retrospective stu...
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Sociedade Brasileira de Urologia
2025-01-01
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| Series: | International Brazilian Journal of Urology |
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| author | David Freire Maia Vieira Cecília Vidal de Souza Torres André de Freitas Secaf Matheus de Moraes Palma Gabriel de Lion Gouvea Jorge Elias Júnior Rodolfo Borges Reis Valdair Muglia |
| author_facet | David Freire Maia Vieira Cecília Vidal de Souza Torres André de Freitas Secaf Matheus de Moraes Palma Gabriel de Lion Gouvea Jorge Elias Júnior Rodolfo Borges Reis Valdair Muglia |
| author_sort | David Freire Maia Vieira |
| collection | DOAJ |
| description | ABSTRACT Purpose: The objective of this study was to evaluate whether morphological (linear measurements) and functional (ADC value) assessments of periprostatic fat can predict the aggressiveness of prostate cancer (PCa) over a 5-year follow-up period. Material and Methods: This retrospective study included patients with histologically proven PCa who underwent 3.0T MRI between July 2016 and June 2018. Clinical and demographic data collected included PSA, PSA density (dPSA), ISUP grade, clinical and pathological staging, and treatment details. MRI-derived parameters were assessed by an experienced radiologist, who measured subcutaneous and periprostatic fat thickness, and calculated ADC values from ROI plots in periprostatic fat. Clinical and MRI parameters were analyzed for associations with biochemical recurrence, systemic metastasis, and PCa-related mortality. Results: After applying exclusion criteria, 109 patients were included. Using the Cox model, dPSA (p<0.01), systemic disease at diagnosis (p<0.01), and mean ADC (p<0.02) were independent predictors of overall survival (OS). For progression-free survival (PFS), only dPSA (p<0.01) and systemic disease at diagnosis (p<0.01) were significant predictors. In the Poisson Model for systemic recurrence risk, dPSA had a relative risk (RR) of 1.04 (95%CI 1.0-1.07, p=0.03), systemic disease at diagnosis had an RR of 63.3 (95%CI 3.7-86.4, p<0.01), and average ADC had an RR of 3.42 (95%CI 1.52-7.69, p<0.01). Conclusions: The ADC value of periprostatic fat may serve as an additional tool for PCa risk stratification, correlating with poorer outcomes such as systemic recurrence and overall survival. If validated by external, prospective, multicenter studies, these findings could impact future therapeutic decisions. |
| format | Article |
| id | doaj-art-1886f199708d41f59094a9cd62cf82a5 |
| institution | Kabale University |
| issn | 1677-6119 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj-art-1886f199708d41f59094a9cd62cf82a52025-02-04T07:36:57ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192025-01-0151110.1590/s1677-5538.ibju.2024.0318Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer AggressivenessDavid Freire Maia Vieirahttps://orcid.org/0000-0003-2920-7710Cecília Vidal de Souza TorresAndré de Freitas SecafMatheus de Moraes PalmaGabriel de Lion GouveaJorge Elias JúniorRodolfo Borges ReisValdair MugliaABSTRACT Purpose: The objective of this study was to evaluate whether morphological (linear measurements) and functional (ADC value) assessments of periprostatic fat can predict the aggressiveness of prostate cancer (PCa) over a 5-year follow-up period. Material and Methods: This retrospective study included patients with histologically proven PCa who underwent 3.0T MRI between July 2016 and June 2018. Clinical and demographic data collected included PSA, PSA density (dPSA), ISUP grade, clinical and pathological staging, and treatment details. MRI-derived parameters were assessed by an experienced radiologist, who measured subcutaneous and periprostatic fat thickness, and calculated ADC values from ROI plots in periprostatic fat. Clinical and MRI parameters were analyzed for associations with biochemical recurrence, systemic metastasis, and PCa-related mortality. Results: After applying exclusion criteria, 109 patients were included. Using the Cox model, dPSA (p<0.01), systemic disease at diagnosis (p<0.01), and mean ADC (p<0.02) were independent predictors of overall survival (OS). For progression-free survival (PFS), only dPSA (p<0.01) and systemic disease at diagnosis (p<0.01) were significant predictors. In the Poisson Model for systemic recurrence risk, dPSA had a relative risk (RR) of 1.04 (95%CI 1.0-1.07, p=0.03), systemic disease at diagnosis had an RR of 63.3 (95%CI 3.7-86.4, p<0.01), and average ADC had an RR of 3.42 (95%CI 1.52-7.69, p<0.01). Conclusions: The ADC value of periprostatic fat may serve as an additional tool for PCa risk stratification, correlating with poorer outcomes such as systemic recurrence and overall survival. If validated by external, prospective, multicenter studies, these findings could impact future therapeutic decisions.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100401&lng=en&tlng=enMorphological and Microscopic FindingsMagnetic Resonance ImagingDiagnosis |
| spellingShingle | David Freire Maia Vieira Cecília Vidal de Souza Torres André de Freitas Secaf Matheus de Moraes Palma Gabriel de Lion Gouvea Jorge Elias Júnior Rodolfo Borges Reis Valdair Muglia Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness International Brazilian Journal of Urology Morphological and Microscopic Findings Magnetic Resonance Imaging Diagnosis |
| title | Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness |
| title_full | Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness |
| title_fullStr | Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness |
| title_full_unstemmed | Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness |
| title_short | Comparison of Morphological and Functional MRI Assessments of Periprostatic Fat for Predicting Prostate Cancer Aggressiveness |
| title_sort | comparison of morphological and functional mri assessments of periprostatic fat for predicting prostate cancer aggressiveness |
| topic | Morphological and Microscopic Findings Magnetic Resonance Imaging Diagnosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382025000100401&lng=en&tlng=en |
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