Prevalence and clinical significance of incidental findings on multiparametric prostate MRI

• DOI: 10.1007/s11547-019-01106-9
• Publication Date: 2019-11-29T08:03:00Z
• Authors: Giuseppe Cutaia; Gaetano Tosto; Roberto Cannella; Alberto Bruno; Claudio Leto; Leonardo Salvaggio; Sofia Cutaia; Francesco Paolo L...; Nino Dispensa; Dario Giambelluca; Massimo Midiri; Giuseppe Salvaggio
• Keywords: Clinical Significance; Prostate Diseases

To assess the prevalence and clinical significance of incidental findings (IFs) detected at multiparametric prostate MRI examination.Multiparametric prostate MRIs of 647 consecutive patients (mean age 67.1 ± 8.0 years) were retrospectively evaluated by two radiologists recording the presence of all extra-prostatic IFs. Findings were classified as related to or not related to genitourinary system and divided into three classes, according to their clinical significance, as follows: group 1, not significant or scarcely significant; group 2, moderately or potentially significant; and group 3, significant. Differences in distribution of IFs between patients ≤ 65 years old and patients > 65 years old were assessed using Pearson's χ2 or Fisher's exact test. Statistical significance level was set at p < 0.05.Incidental findings (n = 461) were present in 341 (52.7%) patients, while 306 (47.3%) patients did not have any extra-prostatic IF. Overall, IFs were significantly more common in patients > 65 years old (n = 225, 57.0%) compared to patients ≤ 65 years old (n = 116, 46.0%, p = 0.007). There were 139 (30.2%) IFs related to genitourinary system and 322 (69.8%) IFs not related to genitourinary system. Group 3 IFs were almost exclusively present in patients > 65 years old (2.8%, p = 0.034) and included 7 (1.1%) bladder carcinomas, 3 (0.5%) testicle tumors, 2 (0.3%) rectal cancers. Twenty-seven (4.2%) of the 647 patients underwent surgical treatment for IFs not directly related to prostate cancer.IFs not related to prostate cancer may be frequently encountered on multiparametric prostate MRI, and they are significantly more common in patients > 65 years old.