Tip of the Iceberg: Inaccuracies in Prostate Cancer Diagnostics

WRITTEN BY: Tara Fernandes

Only 10 percent of icebergs are visible on the water's surface; the remaining 90 percent remains submerged. Similarly, UCLA researchers have found that there could be more to prostate tumors than what is visible in diagnostic images. A study published in the Journal of Urology highlights how magnetic resonance imaging (MRI), commonly used to visualize prostate tumors, often does not paint an accurate picture of tumor size. This disconnect in information can lead to inadequate cancer interventions.

MRI uses powerful magnetic forces and radiofrequency waves to construct incredibly detailed 3-dimensional visual representations of internal body structures such as organs, bones, and tissues. In some techniques, the addition of a contrast medium helps enhance the clarity and resolution of the images generated.

MRI-based procedures are standard practice in the diagnosis and management of prostate cancer. It allows oncologists to analyze the tumor's physical characteristics, which informs which clinical intervention would likely be most effective for eliminating the cancerous tissue—from cryotherapy to laser ablation.

Scientists at the UCLA Jonsson Comprehensive Cancer Center found that this approach might not be as effective as once thought. In a study of over 400 participants, the found that the underestimation of tumor size was particularly pronounced for smaller masses, which had low PI-RADS scores (a scoring system from 1 to 5 used to determine the clinical significance of MRI images of the prostate). To maximize the chances of success, the MRI size measurements and PI-RADS scores must line up, allowing physicians to discern the cancerous tissues from the normal, healthy tissues that border it.

Prostate cancer is the most common cancer in men in the United States. Around 60 percent of cases are diagnosed in men over 65. By improving the ability to differentiate between healthy and malignant tissues, the authors anticipate more successful treatments and a reduction in the number of lives lost from the disease.