Performance of Ultrafast DCE-MRI for Diagnosis of Prostate Cancer

Publication date: Available online 20 November 2017
Source:Academic Radiology
Author(s): Aritrick Chatterjee, Dianning He, Xiaobing Fan, Shiyang Wang, Teodora Szasz, Ambereen Yousuf, Federico Pineda, Tatjana Antic, Melvy Mathew, Gregory S. Karczmar, Aytekin Oto
Rationale and ObjectivesThis study aimed to test high temporal resolution dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for different zones of the prostate and evaluate its performance in the diagnosis of prostate cancer (PCa). Determine whether the addition of ultrafast DCE-MRI improves the performance of multiparametric MRI.Materials and MethodsPatients (n = 20) with pathologically confirmed PCa underwent preoperative 3T MRI with T2-weighted, diffusion-weighted, and high temporal resolution (~2.2 seconds) DCE-MRI using gadoterate meglumine (Guerbet, Bloomington, IN) without an endorectal coil. DCE-MRI data were analyzed by fitting signal intensity with an empirical mathematical model to obtain parameters: percent signal enhancement, enhancement rate (α), washout rate (β), initial enhancement slope, and enhancement start time along with apparent diffusion coefficient (ADC) and T2 values. Regions of interests were placed on sites of prostatectomy verified malignancy (n = 46) and normal tissue (n = 71) from different zones.ResultsCancer (α = 6.45 ± 4.71 s⁻¹, β = 0.067 ± 0.042 s⁻¹, slope = 3.78 ± 1.90 s⁻¹) showed significantly (P < .05) faster signal enhancement and washout rates than normal tissue (α = 3.0 ± 2.1 s⁻¹, β = 0.034 ± 0.050 s⁻¹, slope = 1.9 ± 1.4 s⁻¹), but showed similar percentage signal enhancement and enhancement start time. Receiver operating characteristic analysis showed area under the curve for DCE parameters was comparable to ADC and T2 in the peripheral (DCE 0.67–0.82, ADC 0.80, T2 0.89) and transition zones (DCE 0.61–0.72, ADC 0.69, T2 0.75), but higher in the central zone (DCE 0.79–0.88, ADC 0.45, T2 0.45) and anterior fibromuscular stroma (DCE 0.86–0.89, ADC 0.35, T2 0.12). Importantly, combining DCE with ADC and T2 increased area under the curve by ~30%, further improving the diagnostic accuracy of PCa detection.ConclusionQuantitative parameters from empirical mathematical model fits to ultrafast DCE-MRI improve diagnosis of PCa. DCE-MRI with higher temporal resolution may capture clinically useful information for PCa diagnosis that would be missed by low temporal resolution DCE-MRI. This new information could improve the performance of multiparametric MRI in PCa detection.



http://ift.tt/2A0qhIM