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Multiparametric Magnetic Resonance Imaging of the Prostate for Tumour Detection and Local Staging: Imaging in 1.5T and Histopathologic Correlation

Published on Nov 1, 2017in Canadian Association of Radiologists Journal-journal De L Association Canadienne Des Radiologistes1.009
路 DOI :10.1016/j.carj.2017.02.003
Dimitra Loggitsi2
Estimated H-index: 2
,
Anastasios Gyftopoulos1
Estimated H-index: 1
+ 5 AuthorsNikolaos Kelekis29
Estimated H-index: 29
Abstract
Abstract Purpose The study sought to prospectively evaluate which technique among T2-weighted images, dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), diffusion-weighted (DW) MRI, or a combination of the 2, is best suited for prostate cancer detection and local staging. Methods Twenty-seven consecutive patients with biopsy-proven adenocarcinoma of the prostate underwent MRI on a 1.5T scanner with a surface phased-array coil prior radical prostatectomy. Combined anatomical and functional imaging was performed with the use of T2-weighted sequences, DCE MRI, and DW MRI. We compared the imaging results with whole mount histopathology. Results For the multiparametric approach, significantly higher sensitivity values, that is, 53% (95% confidence interval [CI]: 41.0-64.1) were obtained as compared with each modality alone or any combination of the 3 modalities ( P P 86%) were obtained for both tumour detection and local staging. Conclusions The combination of T2-weighted sequences, DCE MRI, and DW MRI yields higher diagnostic performance for tumour detection and local staging than can any of these techniques alone or even any combination of them.
  • References (29)
  • Citations (2)
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References29
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#1Daniel J. Lee (NewYork鈥揚resbyterian Hospital)H-Index: 3
#2Hashim U. Ahmed (UCL: University College London)H-Index: 46
Last. Behfar Ehdaie (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 25
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Magnetic resonance imaging (MRI) has become increasingly used worldwide in the diagnosis and management of prostate cancer. With advances in multiparametric MRI (mpMRI) technology, such as the use of dynamic contrast-enhanced and diffusion-weighted imaging sequences, observational studies have evaluated the utility for mpMRI in the continuum of prostate cancer management, from improving the detection of clinically significant prostate cancer, to planning radical prostatectomy and radiation thera...
17 CitationsSource
#1Alex Kirkham (UCLH: University College Hospital)H-Index: 25
#2P. Haslam (Freeman Hospital)H-Index: 1
Last. Clare Allen (UCLH: University College Hospital)H-Index: 16
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The current pathway for men suspected of having prostate cancer [transrectal biopsy, followed in some cases by magnetic resonance imaging (MRI) for staging] results in over-diagnosis of insignificant tumours, and systematically misses disease in the anterior prostate. Multiparametric MRI has the potential to change this pathway, and if performed before biopsy, might enable the exclusion of significant disease in some men without biopsy, targeted biopsy in others, and improvements in the performa...
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#1Fatma Nur SoyluH-Index: 4
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The combination of diffusion-weighted and T2-weighted MR images improves specificity and positive predictive value in the diagnosis of seminal vesicle invasion for both experienced and relatively inexperienced radiologists, but does not improve sensitivity, in comparison with reviewing T2-weighted images alone; dynamic contrast-enhanced MR images do not provide additional incremental value.
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Purpose: To prospectively evaluate multiparametric magnetic resonance imaging (MRI) for accurate localization of intraprostatic tumor nodules, with whole-mount histopathology as the gold standard. Materials and Methods: Seventy-five patients with biopsy-proven, intermediate, and high-risk prostate cancer underwent preoperative T2-weighted (T2w), dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI at 1.5T. Localization of suspicious lesions was recorded for each of 24 standardized reg...
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The findings of this retrospective study suggest that computer-aided diagnosis based on a combination of quantitative imaging features derived from multiparametric endorectal MR images might be effective in distinguishing prostate cancer from normal prostate tissue and that apparent diffusion coefficient features and volume transfer constant moderately correlate with tumor Gleason score.
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Interest in integrating MRI into the prostate (CaP) cancer diagnostic pathway seems to be gaining ground [1]. Multiparametric (mp)MRI combines diffusion-weighted, dynamic contrast enhanced sequences or MR spectroscopy with conventional T2-weighted sequences. This has resulted in accuracy rates for the detection of clinically important CaP that compare favorably with established tests, such as X-ray mammography, for the detection of breast cancer [1,2]. However, its exact clinical utility remains...
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Objectives To assess factors influencing prostate cancer detection on multiparametric (T2-weighted, diffusion-weighted, and dynamic contrast-enhanced) MRI.
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Purpose of reviewProstate cancer is the most common solid organ cancer type among American men. Screening and imaging aim to detect early-stage disease that is biologically aggressive. The focus of this study is to review multiparametric MRI in the detection and risk stratification of prostate cance
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#1David Margel (UHN: University Health Network)H-Index: 21
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Purpose: We report magnetic resonance imaging findings among unselected men with low risk prostate cancer before active surveillance.Materials and Methods: We prospectively enrolled men with low grade, low risk, localized prostate cancer. All patients underwent multiparametric endorectal coil magnetic resonance imaging and were offered confirmatory biopsy within 1 year of imaging. The primary outcome was the impact of magnetic resonance imaging on identifying patients who were reclassified by co...
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Purpose: The role of neoadjuvant chemotherapy before surgery in patients with muscle invasive bladder cancer remains debated and the need for tools to identify patients who would benefit from chemotherapy is pertinent. We previously published a preoperative algorithm to predict nonorgan confined disease. This algorithm included tumor markers (CEA, CA 125 and CA 19鈥9) as well as clinical parameters. In this study we validated the accuracy of this algorithm in an independent, external cohort.Mater...
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Purpose This study aims to investigate the role of diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) in combination for the detection of prostate cancer, specifically assessing the role of high b-values (> 1000 s/mm2), with a systematic review and meta-analysis of the existing published data.
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In this meta-analysis study, we compared the oncological and functional outcomes of intrafascial radical prostatectomy (IFRP) with non-intrafascial radical prostatectomy (NIFRP) in the treatment of patients with low risk localized prostate cancer (PCa). Relevant articles were identified by searching PubMed, EMBASE, Cochrane Library, Ovid, and the ISI Web of Knowledge databases. A total of 2096 patients were included from 7 eligible studies. Results of the pooled data showed that the oncological ...
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