Multiparametric magnetic resonance imaging for the detection and characterisation of prostate cancer

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Remote connection: https://oulu.zoom.us/j/68878214073

Topic of the dissertation

Multiparametric magnetic resonance imaging for the detection and characterisation of prostate cancer

Doctoral candidate

Licentiate of Medicine Panu Tonttila

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Subject of study

Medicine

Opponent

Professor Kimmo Taari, Helsinki University Hospital

Custos

Docent Markku H. Vaarala, Oulu University Hospital

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Magnetic resonance imaging for the detection and characterisation of prostate cancer

Current methods to diagnose and characterise prostate cancer with prostate-specific antigen measurement and standard random sextant biopsies have established deficiencies. Magnetic resonance imaging (MRI) has revolutinised prostate cancer diagnostics during the last few years.

In the first, randomized controlled study of the thesis, we recruited men with no previous prostate biopsies. Targeted biopsies from suspicious lesions if found in MRI did not significantly improve the detection rate of prostate cancer. This result has been confirmed later in large multi-center studies. The main advantage of MRI is improved detection of clinically significant cancers. Less clinically insignificant cancers are found if only targeted biopsies are taken. This has to be weighted against >5-10% of clinically significant cancers missed if standard biopsies are avoided.

In the second study of the thesis we estimated the predictive value of MRI lesion diameter for local and lymph node spread of the cancer. MRI lesion diameter was a risk factor for both local spread of tumor through the prostate capsule and for lymph node metastases in the pelvis.

The third study estimated the diagnostic value of MRI for prostate cancer subtypes of invasive cribriform Gleason pattern 4 and intraductal prostate cancer , which have recently been demonstrated to be adverse pathological features. MRI identified 90,5% of tumours including any amount of these subtypes.
Last updated: 29.4.2020