International urology and nephrology · 2026
Charting the unseen: 3D mapping of latent prostate cancer infers its likely origin and growth patterns.
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Jin Shijie, Yang Zhiyuan, Mai Zhipeng, Chen Yuliang, Ren Miao, Zhou Yi, Wang Wenze, Xiao Yu, Zhou Zhien, Yan Weigang
Аннотация
PURPOSE: Latent prostate cancers discovered at autopsy may represent the earliest, subclinical stage of the disease. This study aimed to construct three-dimensional (3D) spatial distribution maps of these tumors to infer their likely origin and growth patterns.
METHODS: A total of 161 tumor lesions from 230 cadaver donors were stratified by volume (V1: 0-0.05 ml; V2: 0.05-0.1 ml; V3: 0.1-0.5 ml; V4: > 0.5 ml) and registered to a standardized MRI-based reference prostate model using Advanced Normalization Tools. Two-dimensional frequency maps were generated per axial layer and stacked into a 3D map.
RESULTS: The smallest tumors (V1) originated almost exclusively in the peripheral zone (83.5%), concentrated in the apical two-thirds of the gland (95.9%), with a uniform distribution across the anterior-posterior and left-right axes. As tumor volume increased (V2 to V4), three distinct growth patterns emerged: (1) increased invasion into the transition zone; (2) horizontal convergence into three "hotspots"-the anterior midline and bilateral posterolateral regions; and (3) vertical concentration within layers III to IX. A compact "susceptible region" occupying only 9.8% of the gland volume harbored 88.2% of the largest (V4) tumors.
CONCLUSION: Latent prostate cancers appear to originate predominantly within the apical-to-mid peripheral zone with an initially uniform spatial distribution. Their growth is anisotropic, favoring the anterior midline and bilateral posterolateral zones while concentrating vertically within the central 20-40% of the prostatic height. These spatial patterns point to target areas that may improve biopsy strategies and focal therapy planning.
METHODS: A total of 161 tumor lesions from 230 cadaver donors were stratified by volume (V1: 0-0.05 ml; V2: 0.05-0.1 ml; V3: 0.1-0.5 ml; V4: > 0.5 ml) and registered to a standardized MRI-based reference prostate model using Advanced Normalization Tools. Two-dimensional frequency maps were generated per axial layer and stacked into a 3D map.
RESULTS: The smallest tumors (V1) originated almost exclusively in the peripheral zone (83.5%), concentrated in the apical two-thirds of the gland (95.9%), with a uniform distribution across the anterior-posterior and left-right axes. As tumor volume increased (V2 to V4), three distinct growth patterns emerged: (1) increased invasion into the transition zone; (2) horizontal convergence into three "hotspots"-the anterior midline and bilateral posterolateral regions; and (3) vertical concentration within layers III to IX. A compact "susceptible region" occupying only 9.8% of the gland volume harbored 88.2% of the largest (V4) tumors.
CONCLUSION: Latent prostate cancers appear to originate predominantly within the apical-to-mid peripheral zone with an initially uniform spatial distribution. Their growth is anisotropic, favoring the anterior midline and bilateral posterolateral zones while concentrating vertically within the central 20-40% of the prostatic height. These spatial patterns point to target areas that may improve biopsy strategies and focal therapy planning.