Dynamic Contrast-Enhanced MRI of Prostate Lesions of Simultaneous [68Ga]Ga-PSMA-11 PET/MRI: Comparison between Intraprostatic Lesions and Correlation between Perfusion Parameters

Abstract

We aimed to retrospectively compare the perfusion parameters measured from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of prostate benign lesions and malignant lesions to determine the relationship between perfusion parameters. DCE-MRI was performed in patients with PCa who underwent simultaneous [68Ga]Ga-prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET)/MRI. Six perfusion parameters (arrival time (AT), time to peak (TTP), wash-in slope (W-in), wash-out slope (W-out), peak enhancement intensity (PEI), and initial area under the 60-s curve (iAUC)), and a semi-quantitative parameter, standardized uptake values maximum (SUVmax) were calculated by placing regions of interest in the largest area of the lesions. The DCE-MRI parameters between prostate benign and malignant lesions were compared. The DCE-MRI parameters in both the benign and malignant lesions subgroup with SUVmax ≤ 3.0 and SUVmax > 3.0 were compared. The correlation of DCE-MRI parameters was investigated. Malignant lesions demonstrated significantly shorter TTP and higher SUVmax than did benign lesions. In the benign and malignant lesions subgroup, perfusion parameters of lesions with SUVmax ≤ 3.0 show no significant difference to those with SUVmax > 3.0. DCE-MRI perfusion parameters show a close correlation with each other. DCE-MRI parameters reflect the perfusion characteristics of intraprostatic lesions with malignant lesions, demonstrating significantly shorter TTP. There is a moderate to strong correlation between DCE-MRI parameters. Semi-quantitative analysis reflects that malignant lesions show a significantly higher SUVmax than benign lesions.

Perfusion Imaging in Deep Prostate Cancer Detection from MP-MRI: Can We Take Advantage of it?

“…Although no strict guidelines could be driven from this study, we showed that, globally, the Tmax, and max slope volume improved detection sensitivity of CS and GS PCa lesions. This is concordant with other studies where the Tmax was found to have a significant impact on the detection of PCa lesions [14]. The mid fusion strategy seems to be beneficial both in terms of detection sensitivity and prostate segmentation.…”

Visualization and Quantification of the Extracellular Matrix in Prostate Cancer Using an Elastin Specific Molecular Probe

“…Elastin is a cross-linked polymer whose cross-linking is difficult to break. Before cross-linking, the soluble precursor tropoelastin forms self-associated aggregates (coacervation) after expression [ 15 ]. Only these non-cross-linked aggregates can be broken down back into the small soluble tropoelastin proteins that can be detected in the Western blot.…”

“…To further improve tissue differentiation, molecular probes could be used as opposed to the currently available unspecific extracellular Gd-based contrast agents [ 15 ]. In addition, molecular imaging could be used as an added tool to current diagnostic techniques.…”

Stratification of prostate cancer patients into low‐ and high‐grade groups using multiparametric magnetic resonance radiomics with dynamic contrast‐enhanced image joint histograms

“…[19][20][21][22][23] In particular, qualitative and semi-quantitative analyses are used to evaluate the temporal changes of contrast agent flows or perfusion within tumors, which can be visualized by a time-intensity curve (TIC). 24 TICs derived from DCE images can be divided into three patterns of wash-out phase within the tumor, that is, progressive, plateau, and wash-out patterns, which might be related to malignancy, 18 but the curves showed poor differentiation of prostate cancer from healthy prostatic tissue. 25 Therefore, in this study, we proposed two-dimensional (2D) joint histograms between different phases of DCE or subtraction phases of DCE (SPD) images for the visualization of temporally changing perfusion patterns in prostate cancer.…”

“…There are qualitative, semi‐quantitative, and quantitative approaches for analyzing DCE images 19–23 . In particular, qualitative and semi‐quantitative analyses are used to evaluate the temporal changes of contrast agent flows or perfusion within tumors, which can be visualized by a time‐intensity curve (TIC) 24 . TICs derived from DCE images can be divided into three patterns of wash‐out phase within the tumor, that is, progressive, plateau, and wash‐out patterns, which might be related to malignancy, 18 but the curves showed poor differentiation of prostate cancer from healthy prostatic tissue 25 …”