Prostate-specific membrane antigen PET/MRI validation of MR textural analysis for detection of transition zone prostate cancer
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To validate MR textural analysis (MRTA) for detection of transition zone (TZ) prostate cancer through comparison with co-registered prostate-specific membrane antigen (PSMA) PET-MR.
Retrospective analysis was performed for 30 men who underwent simultaneous PSMA PET-MR imaging for staging of prostate cancer. Thirty texture features were derived from each manually contoured T2-weighted, transaxial, prostatic TZ using texture analysis software that applies a spatial band-pass filter and quantifies texture through histogram analysis. Texture features of the TZ were compared to PSMA expression on the corresponding PET images. The Benjamini-Hochberg correction controlled the false discovery rate at <5%.
Eighty-eight T2-weighted images in 18 patients demonstrated abnormal PSMA expression within the TZ on PET-MR. 123 images were PSMA negative. Based on the corrected p-value of 0.005, significant differences between PSMA positive and negative slices were found for 16 texture parameters: Standard deviation and mean of positive pixels for all spatial filters (p = <0.0001 for both at all spatial scaling factor (SSF) values) and mean intensity following filtration for SSF 3–6 mm (p = 0.0002–0.0018).
Abnormal expression of PSMA within the TZ is associated with altered texture on T2-weighted MR, providing validation of MRTA for the detection of TZ prostate cancer.
• Prostate transition zone (TZ) MR texture analysis may assist in prostate cancer detection.
• Abnormal transition zone PSMA expression correlates with altered texture on T2-weighted MR.
• TZ with abnormal PSMA expression demonstrates significantly reduced MI, SD and MPP.
KeywordsMagnetic resonance imaging Texture analysis Prostate Cancer Diagnosis
Area under the receiver-operating characteristic curve
Digital rectal exam
Half-Fourier acquisition single-shot turbo spin echo imaging
Mean of positive pixels
MRI textural analysis
Prostate-specific membrane antigen
Peripheral zone of the prostate
Spatial scaling factor
Transition zone of the prostate
Compliance with ethical standards
The scientific guarantor of this publication is Professor Kenneth Miles.
Conflict of interest
The authors of this manuscript declare relationships with the following companies: Professor Kenneth Miles is one of the shareholders of the textural analysis software, TexRad (Feedback PLC, Cambridge, UK).
The authors state that this work has not received any funding.
Statistics and biometry
Professor Kenneth Miles has significant statistical expertise.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• observational study
• performed at one institution
- 1.Cancer Australia (2016) Prostate cancer statistics. Australian Institute of Health and Welfare, Australia. Available via https://prostate-cancer.canceraustralia.gov.au/statistics. Accessed 24 July 2016