Differentiation of prostatic carcinoma and benign prostatic hyperplasia: Correlation between dynamic Gd-DTPA-enhanced MR imaging and histopathology

238

137

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.

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

238

137

“…This technique is also useful for identifying equivocal capsular penetration to assess the involvement of the seminal vesicles (9), and can be used to monitor neoadjuvant hormonal therapy (13). There are, however, conflicting reports as to whether DCE-MRI correlates well with histological grades of prostate carcinoma (8,10,14).…”

mentioning

confidence: 99%

Combined diffusion‐weighted and dynamic contrast‐enhanced MRI for prostate cancer diagnosis—Correlation with biopsy and histopathology

Kozłowski

Chang

Jones

et al. 2006

243

192

Purpose:To determine whether the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI provides higher diagnostic sensitivity for prostate cancer than each technique alone. Materials and Methods:Fourteen patients with a clinical suspicion of prostate cancer underwent endorectal MRI on a 1.5T scanner prior to transrectal ultrasound (TRUS)-guided biopsies. The average values of the apparent diffusion coefficient (ADC, calculated from b-values of 0 and 600), K trans , v e , maximum gadolinium (Gd) concentration, onset time, mean gradient, and maximum enhancement were determined. Correlation with histology was based on biopsy (six patients) and prostatectomy specimen (eight patients) results. The Tukey-Kramer test was used for statistical analysis. Results:The average values of all MRI parameters, except v e and maximum Gd concentration, showed significant differences between tumor and normal prostate. The sensitivity and specificity values were respectively 54% (35-72%) and 100% (95-100%) for the ADC data, and 59% (39 -77%) and 74% (63-83%) for the DCE data. When both ADC and DCE results were combined, the sensitivity increased to 87% (68 -95%) and specificity decreased to 74% (62-83%). Conclusion:All but two DW-and DCE-MRI parameters showed significant differences between tumor and normal prostate. Combining both techniques provides better sensitivity, with a small decrease in specificity.

“…Its diagnostic value in tumor detection, identification, and staging has been shown in breast tumors (1)(2)(3), cervix tumors (4), and prostate carcinoma (5)(6)(7). Also, tumor treatment response has been monitored by DCE-MRI (8 -10), and comparison with histology showed a relationship of DCE-MRI data with angiogenic characteristics such as microvessel density (6,7,11).…”

mentioning

confidence: 99%

Method for quantitative mapping of dynamic MRI contrast agent uptake in human tumors

Rijpkema¹,

Kaanders²,

Joosten³

et al. 2001

164

155

A method is presented for the acquisition and analysis of dynamic contrast-enhanced (DCE) MRI data, focused on the characterization of tumors in humans. Gadolinium (Gd) contrast was administered by bolus injection, and its effect was monitored in time by fast T1-weighted MRI. A simple algorithm was developed for automatic extraction of the arterial input function (AIF) from the DCE-MRI data. This AIF was used in the pixelwise pharmacokinetic determination of physiological vascular parameters in normal and tumor tissue. Maps were reconstructed to show the spatial distribution of parameter values. To test the reproducibility of the method 11 patients with different types of tumors were measured twice, and the rate of contrast agent uptake in the tumor was calculated. The results show that normalizing the DCE-MRI data using individual coregistered AIFs, instead of one common AIF for all patients, substantially reduces the variation between successive measurements. It is concluded that the proposed method enables the reproducible assessment of contrast agent uptake rates.