Quantitative diffusion-weighted imaging and dynamic contrast-enhanced MR imaging for assessment of tumor aggressiveness in prostate cancer at 3T |
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| Affiliation: | 1. Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama 701-0192, Japan;2. Department of Pathology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama 701-0192, Japan;3. Department of Radiology, Radiolonet Tokai, Asaoka-cho 3-86-2, Chikusa-ku, Nagoya-city, Aichi 464-0811, Japan;4. Philips Japan, Konan 2-13-37, Minato-ku, Tokyo 108-8507, Japan;5. Department of Urology, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama 701-0192, Japan;1. Department of Radiology, Tokai University Hospital, Isehara, Kanagawa, Japan;2. Department of Radiological Technology, Faculty of Health Science, Juntendo University, Japan;3. Graduate School of Medical Technology, Teikyo University, Tokyo, Japan;4. Division of Gastroenterology, Department of Internal Medicine, Tokai University, School of Medicine, Isehara, Kanagawa, Japan;5. Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan;1. Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany;2. Department of Radiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;3. Siemens Healthcare GmbH, Erlangen, Germany;4. Department of Neuroradiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;5. Department of Experimental Physics 5 (Biophysics), University of Würzburg, Würzburg, Germany |
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| Abstract: | PurposeTo compare diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MR imaging (DCE-MRI) for characterization of prostate cancer (PC).Methods104 PC patients who underwent prostate multiparametric MRI at 3T including DWI and DCE-MRI before MRI-guided biopsy or radical prostatectomy. Apparent diffusion coefficient (ADC) with histogram analysis (mean, 0–25th percentile, skewness, and kurtosis), intravoxel incoherent motion model including D and f; stretched exponential model including distributed diffusion coefficient (DDC) and a; and permeability parameters including Ktrans, Kep, and Ve were obtained from a region of interest placed on the dominant tumor of each patient.ResultsADCmean, ADC0–25, D, DDC, and Ve were significantly lower and Kep was significantly higher in GS ≥ 3 + 4 tumors (n = 89) than in GS = 3 + 3 tumors (n = 15), and also in GS ≥ 4 + 3 tumors (n = 57) than in GS ≤ 3 + 4 tumors (n = 47) (P < 0.001 to P = 0.040). f was significantly lower in GS ≥ 4 + 3 tumors than in GS ≤ 3 + 4 tumors (P = 0.022), but there was no significant difference between GS = 3 + 3 tumors and GS ≥ 3 + 4 tumors, or between the remaining metrics in both comparisons. In metrics with area under the curve (AUC) >0.80, there was a significant difference in AUC between ADC0–25 and D, and DDC for separating GS ≤ 3 + 4 tumors from GS ≥ 4 + 3 tumors (P = 0.040 and P = 0.022, respectively). There were no significant differences between metrics with AUC > 0.80 for separating GS = 3 + 3 tumors from GS ≥ 3 + 4 tumors. ADC0–25 had the highest correlation with Gleason grade (ρ = −0.625, P < 0.001).ConclusionsDWI and DCE-MRI showed no apparent clinical superiority of non-Gaussian models or permeability MRI over the mono-exponential model for assessment of tumor aggressiveness in PC. |
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