Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study
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To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.
One hundred and seventy-five patients who underwent radical prostatectomy were included. Pre-operative MRI performed at 1.5 T (n = 71) or 3 T (n = 104), with (n = 58) or without (n = 117) an endorectal coil were independently interpreted by two radiologists. A five-point subjective suspicion score (SSS) was assigned to all focal abnormalities (FAs). MR findings were then compared with whole-mount sections.
Readers identified 192–214/362 cancers, with 130–155 false positives. Detection rates for tumours of <0.5 cc (cm3), 0.5–2 cc and >2 cc were 33–45/155 (21–29 %), 15–19/35 (43–54 %) and 8–9/12 (67–75 %) for Gleason ≤6, 17/27 (63 %), 42–45/51 (82–88 %) and 34/35 (97 %) for Gleason 7 and 4/5 (80 %), 13/14 (93 %) and 28/28 (100 %) for Gleason ≥8 cancers respectively. At multivariate analysis, detection rates were influenced by tumour Gleason score, histological volume, histological architecture and location (P < 0.0001), but neither by field strength nor coils used for imaging. The SSS was a significant predictor of both malignancy of FAs (P < 0.005) and aggressiveness of tumours (P < 0.00001).
Detection rates were significantly influenced by tumour characteristics, but neither by field strength nor coils used for imaging. The SSS significantly stratified the risk of malignancy of FAs and aggressiveness of detected tumours.
• Prostate cancer volume, Gleason score, architecture and location are MRI predictors of detection.
• Field strength and coils used do not influence the tumour detection rate.
• Multiparametric MRI is accurate for detecting aggressive tumours.
• A subjective suspicion score can stratify the risk of malignancy and tumour aggressiveness.
KeywordsProstate cancer Magnetic resonance imaging Tumour localisation Gleason score Tumour volume
Multiparametric magnetic resonance imaging
- T2w imaging
- Dw imaging
- DCE imaging
Dynamic contrast enhanced imaging
Magnetic resonance spectroscopy
Subjective suspicion score
Apparent diffusion coefficient
- 2.Rouviere O, Gelet A, Crouzet S, Chapelon JY (2012) Prostate focused ultrasound focal therapy—imaging for the future. Nat Rev Clin Oncol 9:721-727Google Scholar
- 11.Rosenkrantz AB, Mendrinos S, Babb JS, Taneja SS (2012) Prostate cancer foci detected on multiparametric magnetic resonance imaging are histologically distinct from those not detected. J Urol 187:2032-2038Google Scholar
- 12.Isebaert S, Van den Bergh L, Haustermans K et al (2012) Multiparametric MRI for prostate cancer localization in correlation to whole-mount histopathology. J Magn Reson Imaging. doi: 10.1002/jmri.23938
- 29.Woodfield CA, Tung GA, Grand DJ, Pezzullo JA, Machan JT, Renzulli JF 2nd (2010) Diffusion-weighted MRI of peripheral zone prostate cancer: comparison of tumor apparent diffusion coefficient with Gleason score and percentage of tumor on core biopsy. AJR Am J Roentgenol 194:W316–W322PubMedCrossRefGoogle Scholar
- 34.Crehange G, Parfait S, Liegard M et al (2011) Tumor volume and metabolism of prostate cancer determined by proton magnetic resonance spectroscopic imaging at 3T without endorectal coil reveal potential clinical implications in the context of radiation oncology. Int J Radiat Oncol Biol Phys 80:1087–1094PubMedCrossRefGoogle Scholar
- 40.Hughes C, Rouviere O, Mege-Lechevallier F, Souchon R, Prost R (2012) Robust alignment of prostate histology slices with quantified accuracy. IEEE Trans Biomed Eng 60:281-291Google Scholar
- 41.Futterer JJ, Engelbrecht MR, Jager GJ et al (2007) Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal-pelvic phased-array coils. Local staging accuracy of prostate cancer using endorectal coil MR imaging. Eur Radiol 17:1055–1065PubMedCrossRefGoogle Scholar
- 46.Ahmed HU, Kirkham A, Arya M et al (2009) Is it time to consider a role for MRI before prostate biopsy? Nat Rev 6:197–206Google Scholar