Dynamic contrast-enhanced MR evaluation of prostate cancer before and after endorectal high-intensity focused ultrasound

Radiol Med. 2013 Aug;118(5):851-62. doi: 10.1007/s11547-012-0876-9. Epub 2012 Sep 17.

Abstract

Purpose: The authors sought to determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging in the evaluation of prostate cancer before and after transrectal high-intensity focused ultrasound (HIFU) treatment.

Materials and methods: We analysed 25 patients with prostate cancer. The prostate-specific antigen (PSA) value was evaluated 1, 4 and 6 months after treatment. DCE-MR imaging was performed the day prior to and 1, 4 and 6 months after HIFU treatment. Transrectal prostate biopsies were obtained at the time of diagnosis and 6 months after treatment.

Results: Before treatment, intraglandular lesions were considered to be potential sites of neoplasm and subsequently confirmed as sites of prostate adenocarcinoma in all 25 patients based on prostatespecific antigen (PSA) values and histological examinations (rho=1; p<0.001). Using histology as the gold standard, DCE-MR imaging displayed 100% sensitivity, 100% specificity, 100% positive predictive value and 100% negative predictive value before treatment. After HIFU treatment, DCE-MR imaging showed 100% sensitivity and 96% specificity.

Conclusions: DCE-MR imaging can be used to visualise prostate adenocarcinoma. Several morphological and postgadolinium modifications in the follow-up DCE-MR images after HIFU treatment were also observed.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery*
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Contrast Media
  • Humans
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine
  • Middle Aged
  • Organometallic Compounds
  • Predictive Value of Tests
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / surgery*
  • Sensitivity and Specificity
  • Treatment Outcome
  • Ultrasound, High-Intensity Focused, Transrectal*

Substances

  • Contrast Media
  • Organometallic Compounds
  • Meglumine
  • Prostate-Specific Antigen
  • gadoterate meglumine