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Usefulness of grayscale values of hypoechoic lesions matched with target lesions observed on magnetic resonance imaging for the prediction of clinically significant prostate cancer

 Dong Gyun Kim  ;  Jeong Woo Yoo  ;  Kyo Chul Koo  ;  Byung Ha Chung  ;  Kwang Suk Lee 
 BMC UROLOGY, Vol.22(1) : 164, 2022-10 
Journal Title
Issue Date
Humans ; Image-Guided Biopsy / methods ; Magnetic Resonance Imaging / methods ; Male ; Neoplasm Grading ; Prostatic Neoplasms* / pathology ; Retrospective Studies
Grayscale ; Hypoechoic lesion ; Prostate cancer ; Prostate imaging-reporting and data system ; Target biopsy
Background: To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI) according to the Prostate Imaging-Reporting and Data System (PI-RADS).

Methods: We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion-targeted biopsies between January 2017 and September 2020. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values.

Results: Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. There was no difference in the median grayscale values between benign and prostate cancer lesions. However, grayscale ranges (41.8-98.5 and 42.6-91.8) were significant predictors of prostate cancer and clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables (age, prostate-specific antigen levels, prostate volume, previous prostate biopsy results, and PI-RADS scores) was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828; P = 0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (74.5 vs. 58.8, P = 0.008). Grayscale values were the only significant predictive factor (odds ratio = 4.46, P = 0.005) for csPC.

Conclusions: Distribution of grayscale values according to PI-RAD 3 scores was potentially useful, and the grayscale range (42.6-91.8) was a potential predictor for csPC diagnosis.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Yoo, Jeong Woo(유정우)
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
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