1074. Does Periprostatic Fat Thickness Correlate With Increased Tumor Severity in Patients With Clinically Significant Prostate Carcinoma?
Authors * Denotes Presenting Author
  1. Caleb Gilberg *; SUNY Upstate Medical University
  2. Refky Nicola; SUNY Upstate Medical University
To evaluate the significance of periprostatic fat thickness (PFT) as an indicator of tumor severity in patients with clinically significant prostate carcinoma.

Materials and Methods:
This single-center, retrospective study included 110 men (mean age, 64 years; age range, 50-77 years) with clinically significant prostate carcinoma (PCa) who obtained a multiparametric 3T MRI (mpMRI) and subsequent radical prostatectomy between January 1, 2017 and January 1, 2022. The average time between MRI and prostatectomy was 5.16 months (157 days). Clinically significant PCa is defined as having a Gleason score greater than or equal to 7 and a Prostate Imaging Reporting and Data System (PI-RADS) score greater than or equal to 4. PFT was determined by measuring the shortest perpendicular distance between the pubic symphysis and prostate on sagittal T2-weighted MRI. Pearson correlation was conducted to determine the correlation between PFTs and Gleason scores, International Society of Urologic Pathologists (ISUP) grades, seminal vesicle invasion (SVI), perineural invasion (PNI), prostate-specific antigen (PSA) values and lymph node metastasis. Gleason scores, ISUP grades, SVI, PNI, and lymph node metastasis were extracted from post-prostatectomy pathology reports. The mean periprostatic fat thicknesses for PCa lesions of Gleason 7, 8, and 9 were also determined.

The mean PFTs for Gleason scores of 7, 8, and 9 were 4.87 +/- 0.13 mm, 6.56 +/- 1.23 mm, and 7.42 +/- 0.59 mm, respectively. Therefore, mean PFT increased as Gleason score increased. PFT was significantly correlated with Gleason score (r = 0.510, p < 0.001) and ISUP grade (r = 0.429, p < 0.001). However, PFT did not significantly correlate with SVI, PNI, PSA, or lymph node metastasis.

The accurate determination of PCa severity on MRI is critical in the assessment of appropriate clinical and surgical interventions. Statistically significant correlation between PFT on MRI and Gleason and ISUP on post-prostatectomy pathologic analysis establishes PFT as a potential indicator for PCa severity in patients with aggressive PCa. When evaluated together with other indicators for PCa severity, such as PI-RADS scores, PFT measurements could lead to improved outcomes for patients with clinically significant prostate carcinoma.