Aims and objectives
Since to the start,
Diffusion Weighted images in mp-MRI showed its potential in Prostate Cancer (PCa) detection.
Especially,
many studies demonstrated correlation of post-processing Apparent Diffusion Coefficient (ADC) to tumour aggressiveness expressed as Gleason Score (GS) [1].
On the other hand,
the use of contrast introduced and standardized by the Pi-RADS v1 has been recently reviewed in Pi-RADSversion 2,
changing the interpretation of contrastographic behaviour of suspected lesions [2].
Nowadays there isn’t a quantitative parameter on Dynamic Contrast Enhanced (DCE-MRI) that strongly relates to GS...
Methods and materials
Patient selection Fig. 1
84 patients suspected to have PCa on the basis of clinical or laboratory data were enrolled in this retrospective study.
The median age of the patients was 69,4 (64,2-72,3) and the median serum PSA level was 11,2 ng/mL.
All recruited patients underwent a mp-MRI and a TRUS-biopsy was perfomed with a time gap not exceeding 2 months or within at last 6 weeks before mp-MRI.
No one of the enrolled patients had a MRI/TRUS-fusion biopsy.
Patients under pharmacological treatment for Benign...
Results
GS ≥ 6 was considered as a cut-off for positive findings.
A total of 100 suspected foci were observed: 76 of 100 analysed foci have a GS ≥ 6.
66 (86,8%) foci were identified in Peripheral Zone (PZ),
while only 10 (13,2%) were in Transitional Zone (TZ).
Statistical data and distribution of lesions according to GS are showed in Fig. 1
Within the examined group of patients ADC and TTP were significantly lower for cancer tissue than healthy tissue in PZ (p<0,001) [Fig. 4].
However,...
Conclusion
Our findings indicate that both quantitative parameters (ADC and TTP) can predict malignant histology and MRI is a valuable technique to identify high-risk suspicious lesions.
However,
DWI-based quantitative measurement exhibits a stronger association with biopsy findings than TTP.
This means that,
if compared to TTP,
ADC values,
due to its direct correlation with GS,
is able to better define tumour aggressiveness.
Since this study was not intended to investigate the primary detection rate of MRI but its grading ability,
matching of imaging with prostatectomy specimens...
Personal information
All the authors are affiliated with the Radiology School of the University of Genova,
AOU-IRCCS San Martino-IST,
Genova.
References
Turkbey B,
Pinto PA,
Mani H et al. Prostate cancer: value of multiparametric MR imaging at 3T for detection-histopathologic correlation Radiology 2010; 255:89-99
PiRADS v2
Dianat SS,
Carter BH,
Schaffer ME,
Hamper MU,
Epstein IJ,
Macura JK.
Association of quantitative magnetic resonance imaging parameters with histological findings from MRI/ultrasound fusion prostate biopsy.
Canadian Journal of Urology 2015 22;5:7965-7972
KCD Thestrup,
V Logager,
I Baslev,
JM Møller,
R Hvass Hansen,
HS Thomsen (2016) Biparametric versus multiparametric MRI in the diagnosis of prostate cancer.
Acta Radiologica 5(8)...