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Multiparametric MRI for Suspected Recurrent Prostate Cancer after HIFU:Is DCE still needed?

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Abstract

Purpose

To assess the added value of the dynamic contrast-enhanced sequence (DCE) to combination T2-weighted imaging (T2w) + diffusion-weighted imaging (DWI) in detecting prostate cancer (PCa) recurrence after HIFU (high-intensity focused ultrasound).

Methods

Forty-five males with clinical and biological suspected PCa recurrence were retrospectively selected. All underwent multi-parametric MRI (mpMRI) before biopsies. Two readers independently assigned a Likert score of cancer likelihood on T2w + DWI + DCE and T2w + DWI images. Prostatic biopsies were taken as the gold standard.

Results

Recurrent PCa was identified at biopsy for 37 patients (82%). Areas under the receiver-operating curve of T2w + DWI and T2w + DWI + DCE imaging were not significantly different for both readers. Using a Likert score ≥ 3 for the PCa diagnosis threshold, sensitivity at the lobe level for the (1) senior and (2) junior reader for T2w +DWI +DCE sensitivity was (1) 0.97 and (2) 0.94 vs. (1) 0.94 and (2) 0.97 for T2w + DWI.

Conclusion

Accuracy of mpMRI was not significantly improved by adding DCE to T2w + DWI. Sensitivity was high for T2w + DWI + DCE and T2w + DWI with no significant difference for either the junior or senior reader.

Key Points

• MpMRI has the capability to detect PCa recurrence in post-HIFU monitoring.

• The sensitivity of T2w and DWI for detecting PCa recurrence was not improved by DCE.

• Readers with different degrees of experience did not improve their performance with DCE.

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Abbreviations

3D:

3-dimensional

ADC:

Apparent diffusion coefficient

AS:

Anterior fibromuscular stroma

AUROC:

Area under the ROC curve

CSC:

Confidential interval

CI:

Clinically significant cancer

DCE:

Dynamic contrast enhancement sequence

Dw:

Diffusion- weighted imaging

ERBT:

External beam radiation therapy

HIFU:

High-intensity focused ultrasound

IQR:

Interquartile range

mpMRI:

Multiparametric magnetic resonance imaging

MRI:

Magnetic resonance imaging

PCa:

Prostate cancer

PSA:

Prostate-specific antigen

ROI:

Region of interest

ROC:

Receiver-operating characteristic

Se:

Sensitivity

Sp:

Specificity

STB:

Standard biopsy

T2w:

T2-weighted imaging

TB:

Targeted biopsies

TRUS:

Trans-rectal ultrasound

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Academic Department of Radiology, Hopital Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France

    Raïssa Lotte, Malek Ezziane, Paul-Hugo Jouve de Guibert, Olivier Lucidarme & Raphaële Renard-Penna

  2. Academic Department of Statistic, Hopital Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France

    Alexandre Lafourcade & Lisa Belin

  3. Academic Department of Urology, Hopital Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France

    Pierre Mozer & Pierre Conort

  4. Urology Department, Montsouris Institute, F-75014, Paris, France

    Eric Barret

  5. Academic Department of Pathology, Hopital Pitié-Salpétrière, AP-HP, Sorbonne University, Paris, France

    Eva Comperat

  6. Academic Department of Radiology, Hopital Tenon, AP-HP, Sorbonne University, Paris, France

    Sebastian Tavolaro, Franck Boudghene & Raphaële Renard-Penna

  7. GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, F-75020, Paris, France

    Raphaële Renard-Penna

Authors
  1. Raïssa Lotte
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  2. Alexandre Lafourcade
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  3. Pierre Mozer
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  4. Pierre Conort
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  5. Eric Barret
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  7. Malek Ezziane
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  10. Lisa Belin
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Corresponding authors

Correspondence to Raïssa Lotte or Raphaële Renard-Penna.

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Guarantor

The scientific guarantor of this publication is Raphaele Renard Penna.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Alexandre Lafourcade and Lisa Belin (Hopital Pitié Salpétrière) kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was not required because the methodology of the study was retrospective on imaging materials, without any supplementary interventions than routine practice for medical care.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Lotte, R., Lafourcade, A., Mozer, P. et al. Multiparametric MRI for Suspected Recurrent Prostate Cancer after HIFU:Is DCE still needed?. Eur Radiol 28, 3760–3769 (2018). https://doi.org/10.1007/s00330-018-5352-z

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  • DOI: https://doi.org/10.1007/s00330-018-5352-z

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