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Multiparametric MRI of the prostate at 3 T: limited value of 3D 1H-MR spectroscopy as a fourth parameter

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Abstract

Purpose

The aim of our study was to assess whether multiparametric magnetic resonance imaging (MP-MRI) of the prostate with three parameters (PS3: T2-weighted, DWI, and DCE) benefits from an additional fourth parameter (PS4: including 1H-MRSI) in the detection and grading of prostate cancer (PCa) at 3 T.

Methods

MP-MRI was performed in 64 patients (mean 66.7 years, mean PSA 13 ng/ml). Reference standard was obtained by histopathology. Two readers independently evaluated the images. A summation score of each individual parameter for three parameters (PS3) and for four parameters (PS4) was calculated.

Results

In 52 (81.3 %) of 64 patients, histopathology confirmed a PCa. The diagnostic performance for PCa detection of PS4 (O1: 91.7 %, O2: 91.3 %) equaled that of PS3 (O1: 92.8 %, O2: 92.2 %, P > 0.05). Prediction of high-grade PCa by PS4 (O1: 75.1 %, O2: 74.7 %) was as good as with PS3 (O1: 75.1 %, O2: 72.8 %, P > 0.05). Kappa agreement between the two readers was substantial (0.734 PS4) to moderate (0.558 PS3).

Conclusions

MP-MRI with four parameters including 1H-MRSI does not increase the detection and grading of prostate cancer at 3 T compared to MP-MRI with three parameters. A sum score accurately detects PCa at 3 T without an endorectal coil and shows potential for the prediction of tumor grade.

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Authors’ contribution

Stephan Polanec MD involved in project development and data collection/managing and wrote manuscript. Katja Pinker-Domenig MD involved in project development and data analysis and wrote manuscript. Peter Brader MD involved in data analysis and edited the manuscript. Dietmar Georg wrote and edited the manuscript. Shahrokh Shariat MD involved in project development, and wrote and edited the manuscript. Claudio Spick MD involved in data collection, and wrote and edited the manuscript. Martin Susani MD involved in data collection and data analysis. Thomas H. Helbich MD involved in project development and data managing, and wrote and edited the manuscript. Pascal A. Baltzer MD involved in project development and data analysis, and wrote and edited the manuscript.

Author information

Authors and Affiliations

  1. Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria

    Stephan H. Polanec, Katja Pinker-Domenig, Peter Brader, Claudio Spick, Thomas H. Helbich & Pascal A. Baltzer

  2. Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria

    Dietmar Georg

  3. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria

    Dietmar Georg

  4. Department of Urology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria

    Shahrokh Shariat

  5. Clinical Institute of Pathology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria

    Martin Susani

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  1. Stephan H. Polanec
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Correspondence to Thomas H. Helbich or Pascal A. Baltzer.

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Polanec, S.H., Pinker-Domenig, K., Brader, P. et al. Multiparametric MRI of the prostate at 3 T: limited value of 3D 1H-MR spectroscopy as a fourth parameter. World J Urol 34, 649–656 (2016). https://doi.org/10.1007/s00345-015-1670-9

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  • DOI: https://doi.org/10.1007/s00345-015-1670-9

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