European Radiology

, Volume 28, Issue 9, pp 3760–3769 | Cite as

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

  • Raïssa Lotte
  • Alexandre Lafourcade
  • Pierre Mozer
  • Pierre Conort
  • Eric Barret
  • Eva Comperat
  • Malek Ezziane
  • Paul-Hugo Jouve de Guibert
  • Sebastian Tavolaro
  • Lisa Belin
  • Franck Boudghene
  • Olivier Lucidarme
  • Raphaële Renard-Penna



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).


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.


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.


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.


Prostate cancer Neoplasm recurrence, local High-intensity focused ultrasound ablation Diffusion magnetic resonance imaging Contrast media 





Apparent diffusion coefficient


Anterior fibromuscular stroma


Area under the ROC curve


Confidential interval


Clinically significant cancer


Dynamic contrast enhancement sequence


Diffusion- weighted imaging


External beam radiation therapy


High-intensity focused ultrasound


Interquartile range


Multiparametric magnetic resonance imaging


Magnetic resonance imaging


Prostate cancer


Prostate-specific antigen


Region of interest


Receiver-operating characteristic






Standard biopsy


T2-weighted imaging


Targeted biopsies


Trans-rectal ultrasound



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

Compliance with ethical standards


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.


• retrospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2018_5352_MOESM1_ESM.docx (117 kb)
ESM 1 (DOCX 117 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Raïssa Lotte
    • 1
  • Alexandre Lafourcade
    • 2
  • Pierre Mozer
    • 3
  • Pierre Conort
    • 3
  • Eric Barret
    • 4
  • Eva Comperat
    • 5
  • Malek Ezziane
    • 1
  • Paul-Hugo Jouve de Guibert
    • 1
  • Sebastian Tavolaro
    • 6
  • Lisa Belin
    • 2
  • Franck Boudghene
    • 6
  • Olivier Lucidarme
    • 1
  • Raphaële Renard-Penna
    • 1
    • 6
    • 7
  1. 1.Academic Department of RadiologyHopital Pitié-Salpétrière, AP-HP, Sorbonne UniversityParisFrance
  2. 2.Academic Department of StatisticHopital Pitié-Salpétrière, AP-HP, Sorbonne UniversityParisFrance
  3. 3.Academic Department of UrologyHopital Pitié-Salpétrière, AP-HP, Sorbonne UniversityParisFrance
  4. 4.Urology DepartmentMontsouris InstituteParisFrance
  5. 5.Academic Department of PathologyHopital Pitié-Salpétrière, AP-HP, Sorbonne UniversityParisFrance
  6. 6.Academic Department of RadiologyHopital Tenon, AP-HP, Sorbonne UniversityParisFrance
  7. 7.GRC5, ONCOTYPE-Uro, Institut Universitaire de CancérologieParisFrance

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