Impact of Preoperative Imaging (MRI) Modalities on Surgical Planning and Outcome in Prostate Cancer: A Retrospective Analysis

Authors

  • Raza Muhammad
  • Yassar Hussain Patujo
  • Syed Muhammad Hassan Akhtar
  • Shahjehan
  • Hassan Raza Asghar
  • Ruqqayia Adil

DOI:

https://doi.org/10.63682/jns.v14i32S.8227

Keywords:

Prostate Cancer, Radical prostatectomy, Magnetic Resonance Imaging, Apex

Abstract

Background: Operative planning for the treatment of localised prostate cancer has evolved in tandem with advancing imaging technologies. Limited research has examined how these modifications affect recovery times after surgery. The purpose of this research was to determine if magnetic resonance imaging (MRI) performed before surgery had any effect on the percentage of positive surgical margins (PSMs).

Methods: This retrospective comprised of 416 patients of prostate cancer. All the patients were admitted for radical prostatectomy. Patients were divided in two groups. Group I (208) received MRI before radical prostatectomy and group II (208) did not receive MRI before surgery. Post-surgery outcomes were assessed and compared among both groups.

Results: We found mean age in group I was 61.32±8.37 years and in group II mean age was 63.14±6.28 years. Mean operative time and blood loss in group I was lower as compared to group II with p <0.003. In both groups PSM was majority occurred at the apex.Both total and prostatic apex PSM were shown to be linked with preoperative MRI status alone, according to multivariate analysis. Postoperative ischemic syndrome was not linked to the surgical strategy, neurovascular bundle sparing method, or perioperative blood loss.

Conclusion: MRI is a great tool for detecting and treating PCa right now. It is possible to lessen total PSM, apical PSM, and blood loss with the use of this imaging technology. Further, urologists in the early phases of RP have showed encouraging results using preoperative MRI in reducing the PSM rate

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References

Tyson M.D., Andrews P.E., Ferrigni R.F., Humphreys M.R., Parker A.S., Castle E.P. Radical prostatectomy trends in the United States: 1998 to 2011. Mayo Clin Proc. 2016;91:10–16

Johnson D.C., Raman S.S., Mirak S.A., Kwan L., Bajgiran A.M., Hsu W., et al. Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging. Eur Urol. 2019;75:712–720.

Aussavavirojekul P., Hoonlor A., Srinualnad S. Optimization of clinical risk-factor interpretation and radiological findings with machine learning for PIRADS category 3 patients. Prostate. 2022;82:235–244.

van der Leest M., Cornel E., Israel B., Hendriks R., Padhani A.R., Hoogenboom M., et al. Head-to-head comparison of transrectal ultrasound-guided prostate biopsy versus multiparametric prostate resonance imaging with subsequent magnetic resonance-guided biopsy in biopsy-naive men with elevated prostate-specific antigen: a large prospective multicenter clinical study. Eur Urol. 2019;75:570–578

Petralia G, Musi G, Padhani AR, et al (2015) Robot-assisted Radical Prostatectomy: Multiparametric MR Imaging–directed Intraoperative Frozen-Section Analysis to Reduce the Rate of Positive Surgical Margins. Radiology 274:.

Chuang AY, Epstein JI (2008) Positive surgical margins in areas of capsular incision in otherwise organ-confined disease at radical prostatectomy: Histologic features and pitfalls. Am J SurgPathol 32:1201–1206.

Yossepowitch O, Briganti A, Eastham JA, et al (2014) Positive surgical margins after radical prostatectomy: a systematic review and contemporary update. EurUrol 65:303–13.

Gietelink L, Jansen BHE, Oprea-Lager DE, Nieuwenhuijzen JA, Vis AN. Preoperative multiparametric MRI does not lower positive surgical margin rate in a large series of patients undergoing robot-assisted radical prostatectomy. J Robot Surg. 2022;16(2):273–8.

Kozikowski M, Malewski W, Michalak W, Dobruch J. Clinical utility of MRI in the decision-making process before radical prostatectomy: systematic review and meta-analysis. PLoS ONE. 2019;14(1):e0210194.

Haug ES, Myklebust T, Juliebø-Jones P, Reisæter LAR, Aas K, Berg AS, et al. Impact of prebiopsy MRI on Prostate cancer staging: results from the Norwegian Prostate Cancer Registry. BJUI Compass. 2023;4(3):331–8.

Costa DN, Meng X, Tverye A, Bagrodia A, Recchimuzzi DZ, Xi Y, et al. Preoperative multiparametric prostate magnetic resonance imaging structured Report informs risk for positive apical Surgical margins during Radical Prostatectomy. J Comput Assist Tomogr. 2023;47(1):38–44.

Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, et al. ESUR prostate MR guidelines 2012. EurRadiol. 2012;22(4):746–57.

Benidir T, Lone Z, Wood A, Abdallah N, Campbell R, Bajic P et al. Using IsoPSA with PI-RADS score may help refine Biopsy decision making in patients with elevated PSA. Urology. 2023.

Li Y.J., Fu Y., Li W.J., et al. Tumour location determined by preoperative MRI is an independent predictor for positive surgical margin status after Retzius-sparing robot-assisted radical prostatectomy. BJU Int. 2020;126:152–158.

Diamand R., Ploussard G., Roumiguie M., et al. External validation of a multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension and seminal vesicle invasion in prostate cancer patients undergoing radical prostatectomy. Eur Urol. 2021;79:180–185.

Nyarangi-Dix J., Wiesenfarth M., Bonekamp D., et al. Combined clinical parameters and multiparametric magnetic resonance imaging for the prediction of extraprostatic disease—a risk model for patient-tailored risk stratification when planning radical prostatectomy. EurUrol Focus. 2020;6:1205–1212.

Hansomwong T et al. Role of preoperative magnetic resonance imaging on the surgical outcomes of radical prostatectomy: Does preoperative tumor recognition reduce the positive surgical margin in a specific location? Experience from a Thailand prostate cancer specialized center. Asian J Urol. 2023 Oct;10(4):494-501

Joyce DD et al. Effect of Preoperative Multiparametric Magnetic Resonance Imaging on Oncologic and Functional Outcomes Following Radical Prostatectomy. EurUrol Open Sci. 2022 Dec 15;47:87-93.

Peng, Q., Xu, L., Zhang, G. et al. Effect of preoperative PI-RADS assessment on pathological outcomes in patients who underwent radical prostatectomy. Cancer Imaging 23, 113 (2023).

Zhu, M.; Liang, Z.; Feng, T.; Mai, Z.; Jin, S.; Wu, L.; Zhou, H.; Chen, Y.; Yan, W. Up-to-Date Imaging and Diagnostic Techniques for Prostate Cancer: A Literature Review. Diagnostics 2023, 13, 2283.

Sathekge, M.; Lengana, T.; Maes, A.; Vorster, M.; Zeevaart, J.; Lawal, I.; Ebenhan, T.; Van de Wiele, C. (68)Ga-PSMA-11 PET/CT in primary staging of prostate carcinoma: Preliminary results on differences between black and white South-Africans. Eur. J. Nucl. Med. Mol. Imaging 2018, 45, 226–234

Kumar, R.; Singh, S.K.; Mittal, B.R.; Vadi, S.K.; Kakkar, N.; Singh, H.; Krishnaraju, V.S.; Kumar, S.; Bhattacharya, A. Safety and Diagnostic Yield of (68)Ga Prostate-specific Membrane Antigen PET/CT-guided Robotic-assisted Transgluteal Prostatic Biopsy. Radiology 2022, 303, 392–398.

Wibulpolprasert P., Raman S.S., Hsu W., Margolis D.J.A., Asvadi N.H., Khoshnoodi P., et al. Influence of the location and zone of tumor in prostate cancer detection and localization on 3-T multiparametric MRI based on PI-RADS version 2. AJR Am J Roentgenol. 2020; 214:1101–1111.

Jäderling F., Akre O., Aly M., Bjorklund J., Olsson M., Adding C., et al. Preoperative staging using magnetic resonance imaging and risk of positive surgical margins after prostate-cancer surgery. Prostate Cancer Prostatic Dis. 2019;22:391–398

Druskin S.C., Liu J.J., Young A., Feng Z., Dianat S.S., Ludwig W.W., et al. Prostate MRI prior to radical prostatectomy: effects on nerve sparing and pathological margin status. Res Rep Urol. 2017;9:55–63.

Zhang, L.L.; Li, W.C.; Xu, Z.; Jiang, N.; Zang, S.M.; Xu, L.W.; Huang, W.B.; Wang, F.; Sun, H.B. (68)Ga-PSMA PET/CT targeted biopsy for the diagnosis of clinically significant prostate cancer compared with transrectal ultrasound guided biopsy: A prospective randomized single-centre study. Eur. J. Nucl. Med. Mol. Imaging 2021, 48, 483–492..

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Published

2025-07-11

How to Cite

1.
Muhammad R, Patujo YH, Akhtar SMH, Shahjehan S, Asghar HR, Adil R. Impact of Preoperative Imaging (MRI) Modalities on Surgical Planning and Outcome in Prostate Cancer: A Retrospective Analysis. J Neonatal Surg [Internet]. 2025Jul.11 [cited 2025Sep.13];14(32S):5011-6. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/8227

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