Wash‐in rate on the basis of dynamic contrast‐enhanced MRI: Usefulness for prostate cancer detection and localization

Abstract

Purpose:To evaluate the usefulness of the wash-in rate based on dynamic contrast-enhanced (DCE) MRI for the detection and localization of prostate cancer. Materials and Methods:In 53 patients, the wash-in rate was measured in the cancer area and in three normal areas (the peripheral zone, inner portion of the transitional zone, and outer portion of the transitional zone). On the basis of these data, parametric imaging was generated and then its accuracy for cancer detection and location was evaluated compared to that of T2-weighted imaging without the use of an endorectal coil. For that purpose the entire prostate was divided into 18 segments. Results:The wash-in rate value was greater in cancer tissue (9.2/second) than in three normal tissues (3.3/second, 6.7/second, and 3.2/second, respectively; P Ͻ 0.001). The sensitivity and specificity were greater on parametric imaging of the wash-in rate compared to T2-weighted imaging in the entire prostate (96% and 82% vs. 65% and 60%, respectively) and the peripheral zone (96% and 97% vs. 75% and 53%; P Ͻ 0.05). In the transitional zone, the sensitivity was greater on parametric imaging (96%) than on T2-weighted imaging (45%; P ϭ 0.016), but the specificity was similar (51% vs. 73%; P ϭ 0.102). Conclusion:The wash-in rate based on DCE-MRI is a useful parameter for prostate cancer detection and localization.

The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

“…In the transitional and anterior zones, the baseline T2 signal is lower and focal hypo-intense nodules caused by BPH are common; this reduced the detection accuracy of T2WI for cancer in these zones. T2WI alone is estimated to have a sensitivity of 48-88%, specificity of 44-81% and Area Under the Receiver Operating Curve (AUC-ROC) of 0.68-0.81 compared to radical prostatectomy [17][18][19][20][21]. The wide variation in these accuracy estimates is in part due to exclusion of transitional/ anterior cancers and insignificant cancers from the analysis in some studies.…”

Apparent diffusion coefficient: Prostate cancer versus noncancerous tissue according to anatomical region

“…After prostate resection each specimen was step-sectioned into 4-mm slices, as previously described (16). Drawing of histologic maps of the prostate cancer was performed by our faculty pathologists who were unaware of the MR imaging findings.…”

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

“…DCE takes advantage of the unique characteristics associated with the abnormal tumor vasculature to assess aggressiveness of the disease. The usefulness of DCE in detecting, localizing, and staging prostate cancer is well documented in literature [58,[86][87][88][89][90]. Additionally, several studies have reported promising findings on the utility of DCE parameters in discriminating prostate cancer based on aggressiveness of the disease [91,92].…”