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Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology

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Abstract

Objective

To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with apparent diffusion coefficient (ADC) values on corresponding TROIs outlined on pre-operative MRI.

Methods

Men with biopsy-proven prostate adenocarcinoma undergoing multiparametric MRI (mpMRI) prior to prostatectomy were consented to this prospective study. WMP and mpMRI images were viewed using 3D Slicer and each TROI from WMP was contoured on the high b-value ADC maps (b0, 1400). For each TROI outlined on WMP, TCD (tumor cell density) and the percentage of Gleason pattern 3, 4, and 5 were recorded. The ADCmean, ADC10th percentile, ADC90th percentile, and ADCratio were also calculated in each case from the ADC maps using 3D Slicer.

Results

Nineteen patients with 21 tumors were included in this study. ADCmean values for TROIs were 944.8 ± 327.4 vs. 1329.9 ± 201.6 mm2/s for adjacent non-neoplastic prostate tissue (p < 0.001). ADCmean, ADC10th percentile, and ADCratio values for higher grade tumors were lower than those of lower grade tumors (mean 809.71 and 1176.34 mm2/s, p = 0.014; 10th percentile 613.83 and 1018.14 mm2/s, p = 0.009; ratio 0.60 and 0.94, p = 0.005). TCD and ADCmean (ρ = −0.61, p = 0.005) and TCD and ADC10th percentile (ρ = −0.56, p = 0.01) were negatively correlated. No correlation was observed between percentage of Gleason pattern and ADC values.

Conclusion

DWI MRI can characterize focal prostate cancer using ADCratio, ADC10th percentile, and ADCmean, which correlate with pathological tumor cell density.

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Acknowledgments

The authors thank Louise Greenberg, M.Ed. for coordination of this study and Nina Geller Ph.D. for editing assistance.

Grant Support

Grant funding was provided by U01CA151261 (FMF, AF), U24CA180918 (AF), R25CA89017 (DIG), P41EB015898 (CT, FF, AF), and DPH403516 (EH).

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Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Daniel I. Glazer, Elmira Hassanzadeh, Andriy Fedorov, Olutayo I. Olubiyi, Shayna S. Goldberger, Clare M. Tempany & Fiona M. Fennessy

  2. Department of Radiology, Charité University Hospital, Berlin, Germany

    Tobias Penzkofer

  3. Division of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON, K1H 8L6, Canada

    Trevor A. Flood

  4. University of Ottawa, Ottawa, ON, K1H 8L6, Canada

    Trevor A. Flood

  5. Department of Pathology, Humber River Hospital, Toronto, ON, M3M 0B2, Canada

    Paul Masry

  6. Department of Radiology, Boston Children’s Hospital, Boston, MA, 02115, USA

    Robert V. Mulkern

  7. Department of Pathology, Brigham and Women’s Hospital , Boston, MA, USA

    Michelle S. Hirsch

  8. Department of Radiology, Dana Farber Cancer Institute, Boston, MA, 02115, USA

    Fiona M. Fennessy

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  1. Daniel I. Glazer
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Corresponding author

Correspondence to Daniel I. Glazer.

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Ethical approval

The study was HIPAA compliant and approved by the Institutional Review Board. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Glazer, D.I., Hassanzadeh, E., Fedorov, A. et al. Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: correlation with tumor cell density and percentage Gleason pattern on whole mount pathology. Abdom Radiol 42, 918–925 (2017). https://doi.org/10.1007/s00261-016-0942-1

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