ArticleJournal of Korean medical science2026
Correlation Between the Natural Course and Magnetic Resonance Imaging Features of Bacillus Calmette-Guérin-Related Granulomatous Prostatitis in Patients With Bladder Cancer.
Article in Journal of Korean medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate magnetic resonance imaging features and the natural course of granulomatous prostatitis after intravesical Bacillus Calmette-Guérin therapy in patients with bladder cancer.
methodsUsing a radiologic report keyword search program, data were collected from magnetic resonance images between March 2018 and August 2023. A total of 241 baseline or follow-up magnetic resonance images of 64 patients with pathologically or clinically confirmed Bacillus Calmette-Guérin-related granulomatous prostatitis were retrospectively included. We investigated intravesical Bacillus Calmette-Guérin history, lesion size changes, and serum prostate-specific antigen changes through a chart review. Lesion imaging features were assessed on T1-. T2-, diffusion-, and contrast-enhanced T1-weighted images and classified based on enhancement degree and presence of diffusion restriction.
resultThe completely improved group (n = 12), incompletely improved group (n = 26), and recurrent inflammation group (n = 13) were identified according to temporal magnetic resonance imaging changes of granulomatous prostatitis. Patients who underwent radical cystectomy or were lost to follow-up were excluded due to unknown outcomes (n = 13). Among 64 patients, subtle increased T1 signal intensity with granulomatous inflammation was observed in 57 (89.1%). The baseline prostate-specific antigen level in the recurrent inflammation group was 2.00 ± 1.26 ng/mL, which was higher than the 1.0-1.1 ng/mL levels in the other groups (
conclusionIn patients who underwent intravesical Bacillus Calmette-Guérin therapy, bladder magnetic resonance imaging frequently revealed subtle T1-hyperintense lesion in the prostate with diffuse or rim-like enhancement accompanied by markedly restricted diffusion, which is highly suggestive of Bacillus Calmette-Guérin-related granulomatous prostatitis and tends to spontaneously regress on follow-up imaging. Even with radiological improvement, prostate-specific antigen levels may remain elevated and should not be mistaken for malignancy.
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