Common incidentalomas on prostate MRI: The importance of seeing the whole picture
Number:28ESURABS0049
Type:Educational Electronic Presentation
Authors: Beatriz Rebelo, José Venâncio
Keywords:incidental findings, mpMR, prostate, cancer, diagnosis
SECTIONS
Educational objective

To highlight potential incidental findings that radiologists may encounter in

multiparametric MR (mpMR) of the prostate, with cases from our institution.

Topic Review

The use of multiparametric magnetic resonance imaging (mpMP) for the evaluation of prostate cancer has increased, guiding several aspects of prostate cancer management. It plays a significant role in diagnosing clinically significant cancer, staging, and evaluation of response to treatment of prostate cancer.

It is important to remember that prostate mpMR is not limited to the prostate gland and includes the whole pelvis in its field of view, with multiple structures of the

musculoskeletal, genitourinary and gastrointestinal systems.

A systemic approach, with a review of the different abdominal and pelvic organs, is essential to identify these abnormalities, which may be malignant. Some especially important areas are the bone, the rectum and the bladder.

As the number of patients being scanned increases, so does the frequency of these

findings,...

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Figure 1 – Piriform Sindrome. Prostatic MRI: axial (A) and coronal (B) T2WI. There is asymmetry of the piriformis muscle, with hypertrophy on the right (red arrow), keeping with piriform síndrome in this patient with leg pain, initially thought to be due to bone metastasis from prostatic carcinoma
Figure 2 – Bone metastesis. Prostatic MRI: axial T2WI (A) and T1WI (B) (C). There are numerous bone lesions centered at the iliac bones (arrows), hipointense on T2WI and T1WI suspicious for bone metastesis.
Conclusions

Recognition of potential incidental findings in prostate MR may help radiologists

prevent diagnostic errors that may compromise appropriate therapeutic

management.

 

Bibliography:

1 - Elmi A., et al. Incidental findings at initial imaging workup of patients with prostate cancer: clinical significance and outcomes. Am J Roentgenol (2012);199: 1305e11.

2 - Ho, A. A. et al. A PSA for Radiologists: Pictorial Review of Incidentalomas on Prostate

Magnetic Resonance Imaging. Canadian Association of Radiologists Journal xx (2019) 1-13

3 - Kuhn F.P et al. Prevalence of simple and complex sacral perineural Tarlov cysts in a French cohort of adults and children. J Neuroradiol (2017); 44:38e43.

4- Vargas HA,...

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