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Dynamic contrast-enhanced (DCE) MR imaging: the role of qualitative and quantitative parameters for evaluating prostate tumors stratified by Gleason score and PI-RADS v2

Abstract

Purpose

To investigate the role of qualitative and quantitative DCE-MRI parameters in prostate cancer (PCa) stratified by whole-mount histopathology (WMHP) Gleason score (GS) and PI-RADSv2.

Methods

This retrospective study included 323 PCa tumors in 254 men, who underwent 3T MRI prior to prostatectomy, 7/2009-12/2016. Qualitative DCE curve types included type 1 (progressive), type 2 (plateau) and type 3 (washout). Quantitative DCE-MRI pharmacokinetic (PK) parameters included Ktrans (influx volume transfer coefficient), Kep (efflux reflux rate constant) and iAUC (initial area under the curve). DCE-MRI features of true positive lesions were evaluated for overall, index, transition zone (TZ) and peripheral zone (PZ), based on GS grade (low = 6, high > 6) and PI-RADSv2 score using SPSSv24.

Results

There were 57 (17.6%) low-grade and 266 (82.4%) high-grade PCa lesions. PI-RADSv2 3, 4 and 5 included 106, 120 and 97 lesions, respectively. 251 (77.7%) and 72 (22.3%) lesions were located in PZ and TZ, respectively. High-grade lesions had significantly higher proportion of Type 3 curves compared to low-grade lesions in overall (70.3% vs. 54.4%) and TZ (73.5% vs. 43.5%). As PI-RADSv2 increased, the proportion of type 3 curve significantly increased for overall (80.4–51.9%), index (80.4–54.7%) and PZ (78.7–52.1%) lesions. Among PK parameters, Ktrans (0.43 vs 0.32) and iAUC (8.99 vs 6.9) for overall PCa, Ktrans (0.43 vs 0.31) and iAUC (9 vs 6.67) for PZ PCa, and iAUC (8.94 vs 7.42) for index PCa were significantly higher for high-grade versus low-grade lesions. Also, Ktrans (0.51–0.34), Kep (1.75–1.29) and iAUC (9.79–7.6) for overall PCa, Ktrans (0.53–0.32), Kep (1.81–1.26) and iAUC (9.83–7.34) for PZ PCa; and Kep (1.79–1.17) and iAUC (11.3–8.45) for index PCa increased significantly with a higher PI-RADSv2 score.

Conclusions

The results of study show the possible utility of qualitative and quantitative DCE-MRI parameters for assessment of PCa GS and PI-RADSv2 categorization.

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Acknowledgements

This work was supported by funds from the Integrated Diagnostics Program, Department of Radiological Sciences & Department of Pathology and Laboratory Medicine in our institution. We are grateful to Dr. Melina Hosseini and Dr. Sepideh Shakeri for editing the final version of the manuscript.

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Correspondence to Sohrab Afshari Mirak.

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This study was performed in accordance with the 1996 Health Information Portability and Accountability Act (HIPAA) and under waiver of informed consent by the institutional review board (IRB).

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Afshari Mirak, S., Mohammadian Bajgiran, A., Sung, K. et al. Dynamic contrast-enhanced (DCE) MR imaging: the role of qualitative and quantitative parameters for evaluating prostate tumors stratified by Gleason score and PI-RADS v2. Abdom Radiol 45, 2225–2234 (2020). https://doi.org/10.1007/s00261-019-02234-6

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  • DOI: https://doi.org/10.1007/s00261-019-02234-6

Keywords

  • Prostate cancer
  • Magnetic resonance imaging
  • Perfusion imaging
  • Prostate Imaging and Reporting Data System