Combined Use of Diffusion-Weighted MRI and <sup>1</sup>H MR Spectroscopy to Increase Accuracy in Prostate Cancer Detection

Reinsberg, Stefan A.; Payne, Geoffrey S.; Riches, Sophie F.; Ashley, Sue; Brewster, J M; Morgan, Veronica A.; deSouza, Nandita M.

doi:10.2214/ajr.05.2198

Cited by 166 publications

(148 citation statements)

References 26 publications

(35 reference statements)

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“…Chen et al (45) found that DWI (82%) and MRS (84%) had similar sensitivity but DWI had lower specificity (82%) compared with MRS (98%). In contrast, Reinsberg et al (46) instead showed slightly lower sensitivity and specificity rates of DWI compared with that of MRS, particularly when the percentage of tumor within the voxel was smaller.…”

Section: Discussionmentioning

confidence: 88%

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

Nagarajan

Margolis

Raman

et al. 2012

Magnetic Resonance Imaging

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Purpose: To investigate functional changes in prostate cancer patients with three pathologically proven different Gleason scores (GS) (3þ3, 3þ4, and 4þ3) using magnetic resonance spectroscopic imaging (MRSI) and diffusionweighted imaging (DWI). Materials and Methods:In this study MRSI and DWI data were acquired in 41 prostate cancer patients using a 1.5T MRI scanner with a body matrix combined with an endorectal coil. The metabolite ratios of (ChoþCr)/Cit were calculated from the peak integrals of total choline (Cho), creatine (Cr), and citrate (Cit) in MRSI. Apparent diffusion coefficient (ADC) values were derived from DWI for three groups of Gleason scores. The sensitivity and specificity of MRSI and DWI in patients were calculated using receiver operating characteristic curve (ROC) analysis. Results:The mean and standard deviation of (ChoþCr)/ Cit ratios of GS 3þ3, GS 3þ4, and GS 4þ3 were: 0.44 6 0.02, 0.56 6 0.06, and 0.88 6 0.11, respectively. For the DWI, the mean and standard deviation of ADC values in GS 3þ3, GS 3þ4, and GS 4þ3 were: 1.13 6 0.11, 0.97 6 0.10, and 0.83 6 0.08 mm 2 /sec, respectively. Statistical significances were observed between the GS and metabolite ratio as well as ADC values and GS.Conclusion: Combined MRSI and DWI helps identify the presence and the proportion of aggressive cancer (ie, Gleason grade 4) that might not be apparent on biopsy sampling. This information can guide subsequent rebiopsy management, especially for active surveillance programs.

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Section: Discussionmentioning

confidence: 88%

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

Nagarajan

Margolis

Raman

et al. 2012

Magnetic Resonance Imaging

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show abstract

“…Chen et al [48] found that DWI (82%) and MRS (84%) had similar sensitivity but DWI had lower specificity (82%) compared with MRS (98%). Reinsberg et al instead showed slightly lower sensitivity and specificity rates of DWI compared with MRS, particularly when the percentage of tumour within the voxel was smaller (see section on voxel size) [50]. Mazaheri et al found that the AUC for DWI was higher (0.81) than for MRS (0.74), but results were better when both techniques were combined (0.85).…”

Section: Mr Spectroscopymentioning

confidence: 99%

“…Reinsberg et al [50] noted that DWI with the tumour occupying approximately 30% of the voxel, sensitivity and specificity were 67% and 60%, but when tumour occupied approximately 70% of the voxel, sensitivity and specificity increased to 93% and 57% respectively. In the recent study by Langer et al [64] it was shown that DWI is unable to differentiate between sparse PC (as defined by tumour of less than 40% within the lesion) and normal PZ tissue.…”

Section: Voxel Sizementioning

confidence: 99%

Diffusion weighted imaging in prostate cancer

2010

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Diffusion-weighted imaging has generated substantial interest in the hope that it can be developed into a robust technique to improve the accuracy of MRI for the evaluation of prostate cancer. This technique has the advantages of short acquisition times, no need for intravenous administration of contrast medium, and the ability to study diffusion of water molecules that indirectly reflects tissue cellularity. In this article, we review the existing literature on the utility of DWI in tumour detection, localisation, treatment response, limitations of the technique, how it compares with other imaging techniques, technical considerations and future directions.

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“…In recent years, the utility of diffusion-weighted imaging (DWI) in the diagnosis of prostate cancer has been reported in a number of preliminary studies, leading to high expectations for clinical applications as an additional method to T2-weighted imaging, dynamic MR studies, and MR spectroscopic imaging (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). However, all of these studies have focused on comparisons between cancer and normal regions in prostate cancer patients and limited cases of healthy individuals.…”

mentioning

confidence: 99%

Apparent diffusion coefficient values in peripheral and transition zones of the prostate: Comparison between normal and malignant prostatic tissues and correlation with histologic grade

Tamada

Sone

et al. 2008

Magnetic Resonance Imaging

238

137

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Purpose:To investigate the utility of apparent diffusion coefficient (ADC) values for discriminating tumor in patients with prostate cancer from normal prostatic tissues in healthy adult men, and to identify correlations between ADC and histologic grade of prostate cancer. Materials and Methods:A total of 125 healthy male volunteers (mean age, 60 years; range, 50 -86 years) and 90 prostate cancer patients (mean age, 71 years; range, 51-88 years) underwent diffusion-weighted imaging (DWI) of the prostate with a single-shot echo-planar imaging sequence using b-factors of 0 and 800 sec/mm 2 . ADC was measured from two locations in the peripheral zone (PZ) and two locations in the central gland (CG) in normal subjects, and tumor locations of PZ or transition zone (TZ) in patients with prostate cancer. Results:Mean ADC values of tumor regions in both PZ (1.02 Ϯ 0.25 ϫ 10 Ϫ3 mm 2 /sec) and TZ (0.94 Ϯ 0.21 ϫ 10 Ϫ3 mm 2 /sec) were significantly lower than those in the corresponding normal regions (1.80 Ϯ 0.27 ϫ 10 Ϫ3 mm 2 /sec and 1.34 Ϯ 0.14 ϫ 10 Ϫ3 mm 2 /sec, respectively) (P Ͻ 0.0001 each). Furthermore, a significant negative correlation was identified between ADC in PZ cancer and tumor Gleason score ( ϭ Ϫ0.497, P Ͻ 0.0001). Conclusion:ADC values appear to provide acceptable diagnostic accuracy in both PZ and TZ.

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Combined Use of Diffusion-Weighted MRI and ¹H MR Spectroscopy to Increase Accuracy in Prostate Cancer Detection

Abstract: When voxels containing > or = 70% tumor are considered positive, the combined use of MR spectroscopy and diffusion-weighted MRI increases the specificity for prostate cancer detection while retaining the sensitivity compared with MR spectroscopy alone or diffusion-weighted MRI alone.

Cited by 166 publications

References 26 publications

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

Diffusion weighted imaging in prostate cancer

Apparent diffusion coefficient values in peripheral and transition zones of the prostate: Comparison between normal and malignant prostatic tissues and correlation with histologic grade

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Combined Use of Diffusion-Weighted MRI and 1H MR Spectroscopy to Increase Accuracy in Prostate Cancer Detection

Abstract: When voxels containing > or = 70% tumor are considered positive, the combined use of MR spectroscopy and diffusion-weighted MRI increases the specificity for prostate cancer detection while retaining the sensitivity compared with MR spectroscopy alone or diffusion-weighted MRI alone.

Cited by 166 publications

References 26 publications

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

MR spectroscopic imaging and diffusion‐weighted imaging of prostate cancer with Gleason scores

Diffusion weighted imaging in prostate cancer

Apparent diffusion coefficient values in peripheral and transition zones of the prostate: Comparison between normal and malignant prostatic tissues and correlation with histologic grade

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Combined Use of Diffusion-Weighted MRI and ¹H MR Spectroscopy to Increase Accuracy in Prostate Cancer Detection