Detection of prostate cancer in peripheral zone: comparison of MR diffusion tensor imaging,quantitative dynamic contrast-enhanced MRI,and the two techniques combined at 3.0 T

Abstract

Background

Previous studies have shown that the diagnostic accuracy for prostate cancer improved with diffusion tensor imaging (DTI) or quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) only. However, the efficacy of combined DTI and quantitative DCE-MRI in detecting prostate cancer at 3.0 T is still indeterminate.

Purpose

To investigate the utility of diffusion tensor imaging (DTI), quantitative DCE-MRI, and the two techniques combined at 3.0 T in detecting prostate cancer of the peripheral zone (PZ).

Material and Methods: DTI and DCE-MRI of 33 patients was acquired prior to prostate biopsy. Regions of interest (ROIs) were drawn according to biopsy zones which were apex, mid-gland, and base on each side of the PZ. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), volume transfer constant (K^trans), and rate constant (k_ep) values of cancerous sextants and non-cancerous sextants in PZ were calculated. Logistic regression models were generated for DTI, DCE-MRI, and DTI + DCE-MRI. Receiver-operating characteristic (ROC) curves were used to compare the ability of these models to differentiate cancerous sextants from non-cancerous sextants of PZ.

Results

There were significant differences in the ADC, FA, K^trans, and k_ep values between cancerous sextants and non-cancerous sextants in PZ (P < 0.0001, P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The area under curve (AUC) for DTI + DCE-MRI was significantly greater than that for either DTI (0.93 vs. 0.86, P = 0.0017) or DCE-MRI (0.93 vs. 0.84, P = 0.0034) alone.

Conclusion

The combination of DTI and quantitative DCE-MRI has better diagnostic performance in detecting prostate cancer of the PZ than either technique alone.

Keywords

Diffusion tensor imaging dynamic contrast-enhanced MRI prostate cancer

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References

Jemal

Bray

Center

. Global cancer statistics. CA Cancer J Clin 2011; 61: 69–90.

Villeirs

Oosterlinck

Vanherreweghe

. A qualitative approach to combined magnetic resonance imaging and spectroscopy in the diagnosis of prostate cancer. Eur J Radiol 2010; 73: 352–356.

Saito

Kaminaga

Muto

. Clinical efficacy of proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis of localized prostate cancer. Anticancer Res 2008; 28: 1899–1904.

Katahira

Takahara

Kwee

. Ultra-high-b-value diffusion-weighted MR imaging for the detection of prostate cancer: evaluation in 201 cases with histopathological correlation. Eur Radiol 2011; 21: 188–196.

Rosenkrantz

Mannelli

Kong

. Prostate cancer: utility of fusion of T2-weighted and high b-value diffusion-weighted images for peripheral zone tumor detection and localization. J Magn Reson Imaging 2011; 34: 95–100.

Vargas

Akin

Franiel

. Diffusion-weighted endorectal MR imaging at 3 T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 2011; 259: 775–784.

Oto

Kayhan

Jiang

. Prostate cancer: differentiation of central gland cancer from benign prostatic hyperplasia by using diffusion-weighted and dynamic contrast-enhanced MR imaging. Radiology 2010; 257: 715–723.

Delongchamps

Rouanne

Flam

. Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2-weighted, dynamic contrast-enhanced and diffusion-weighted imaging. BJU Int 2011; 107: 1411–1418.

Basser

Pierpaoli

. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 1996; 111: 209–219.

10.

Reischauer

Wilm

Froehlich

. High-resolution diffusion tensor imaging of prostate cancer using a reduced FOV technique. Eur J Radiol 2011; 80: 34–41.

11.

Gibbs

Pickles

Turnbull

. Diffusion imaging of the prostate at 3.0 tesla. Invest Radiol 2006; 41: 185–188.

12.

Manenti

Carlani

Mancino

. Diffusion tensor magnetic resonance imaging of prostate cancer. Invest Radiol 2007; 42: 412–419.

13.

Gürses

Kabakci

Kovanlikaya

. Diffusion tensor imaging of the normal prostate at 3 Tesla. Eur Radiol 2008; 18: 716–721.

14.

Gürses

Tasdelen

Yencilek

. Diagnostic utility of DTI in prostate cancer. Eur Radiol 2011; 79: 172–176.

15.

Tofts

Brix

Buckley

. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 1999; 10: 223–232.

16.

Choyke

Dwyer

Knopp

. Functional tumor imaging with dynamic contrast-enhanced magnetic resonance imaging. J Magn Reson Imaging 2003; 17: 509–520.

17.

Kozlowski

Chang

Jones

. Combined diffusion-weighted and dynamic contrast-enhanced MRI for prostate cancer diagnosis–correlation with biopsy and histopathology. J Magn Reson Imaging 2006; 24: 108–113.

18.

van Dorsten

van der Graaf

Engelbrecht

. Combined quantitative dynamic contrast-enhanced MR imaging and (1)H MR spectroscopic imaging of human prostate cancer. J Magn Reson Imaging 2004; 20: 279–287.

19.

Schlemmer

Merkle

Grobholz

. Can pre-operative contrast-enhanced dynamic MR imaging for prostate cancer predict microvessel density in prostatectomy specimens. Eur Radiol 2004; 14: 309–317.

20.

Ocak

Bernardo

Metzger

. Dynamic contrast-enhanced MRI of prostate cancer at 3 T: a study of pharmacokinetic parameters. Am J Roentgenol 2007; 189: 192–201.

21.

Farrell

Landman

Jones

. Effects of signal-to-noise ratio on the accuracy and reproducibility of diffusion tensor imaging-derived fractional anisotropy, mean diffusivity, and principal Eigenvector measurements at 1.5T. J Magn Reson Imaging 2007; 26: 756–767.

22.

Brix

Semmler

Port

. Pharmacokinetic parameters in CNS Gd-DTPA enhanced MR imaging. J Comput Assist Tomogr 1991; 15: 621–628.

23.

Furman-Haran

Margalit

Grobgeld

. Dynamic contrast-enhanced magnetic resonance imaging reveals stress-induced angiogenesis in MCF7 human breast tumors. Proc Natl Acad Sci U S A 1996; 93: 6247–6251.

24.

de Rochefort

Nguyen

Brown

. In vivo quantification of contrast agent concentration using the induced magnetic field for time-resolved arterial input function measurement with MRI. Med Phys 2008; 35: 5328–5339.

25.

Chen

Dang

Wang

. Prostate cancer detection: comparison of T2-weighted imaging, diffusion-weighted imaging, proton magnetic resonance spectroscopic imaging, and the three techniques combined. Acta Radiol 2008; 49: 602–610.

26.

Humphrey

Kibel

. Magnetic resonance diffusion characteristics of histologically defined prostate cancer in humans. Magn Reson Med 2009; 61: 842–850.

27.

Padhani

Gapinski

Macvicar

. Dynamic contrast enhanced MRI of prostate cancer: correlation with morphology and tumor stage, histological grade and PSA. Clin Radiol 2000; 55: 99–109.

28.

Kozlowski

Chang

Meng

. Combined prostate diffusion tensor imaging and dynamic contrast enhanced MRI at 3T — quantitative correlation with biopsy. Magn Reson Imaging 2010; 28: 621–628.