MRI Identifies Chronic Prostatitis From Cancer
High levels of prostate-specific antigen (PSA) present a challenge for physicians, since high PSA can occur in men who have prostate cancer or chronic prostatitis, or both. A high PSA typically causes doctors to suspect prostate cancer, which can prompt them to order potentially unnecessary tests such as prostate biopsy.
Although conventional MRIs are not adequate for distinguishing between prostate cancer and prostatitis, some experts believe a specific type of MRI —high spatial resolution dynamic contrast-enhanced MRI, or HR-CE-MRI—is superior to the conventional approach. If true, this new technique could reduce unneeded procedures and stress associated with the uncertainty of knowing whether one has prostate cancer.
Fifty-four men with prostate cancer who were scheduled for prostatectomy underwent HR-CE-MRI of the prostate, and features of the MRIs suggestive of chronic prostatitis were compared to specimens obtained during surgery. Clinicians observed specific features suggestive of chronic prostatitis which contrasted with those of prostate cancer.
Based on their preliminary results, the authors reported that the HR-CE-MRI method was accurate for differentiating between prostate cancer and chronic prostatitis and “can lead to more accurate MRI staging or prostate cancer which can affect treatment choice and clinical outcome.” If this MRI may help distinguish chronic prostatitis from prostate cancer, it also could offer more peace of mind to men who find themselves in this position.