Dynamic contrast-enhanced (DCE) MR imaging: the role of qualitative and quantitative parameters for evaluating prostate tumors stratified by Gleason score and PI-RADS v2

Sohrab Afshari Mirak; Amirhossein Mohammadian Bajgiran; Kyunghyun Sung; Nazanin H Asvadi; Daniela Markovic; Ely R Felker; David Lu; Anthony Sisk; Robert E Reiter; Steven S Raman

doi:10.1007/s00261-019-02234-6

Dynamic contrast-enhanced (DCE) MR imaging: the role of qualitative and quantitative parameters for evaluating prostate tumors stratified by Gleason score and PI-RADS v2

Abdom Radiol (NY). 2020 Jul;45(7):2225-2234. doi: 10.1007/s00261-019-02234-6.

Affiliations

¹ Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA, 90095, USA. safsharimirak@mednet.ucla.edu.
² Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
³ Department of Pathology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, AS-370 CHS, Los Angeles, CA, 90095, USA.
⁴ Department of Urology, David Geffen School of Medicine at UCLA, Clark Urology Center - Westwood, 200 UCLA Medical Plaza, Suite 140, Los Angeles, CA, 90095, USA.

Abstract

Purpose: To investigate the role of qualitative and quantitative DCE-MRI parameters in prostate cancer (PCa) stratified by whole-mount histopathology (WMHP) Gleason score (GS) and PI-RADSv2.

Methods: This retrospective study included 323 PCa tumors in 254 men, who underwent 3T MRI prior to prostatectomy, 7/2009-12/2016. Qualitative DCE curve types included type 1 (progressive), type 2 (plateau) and type 3 (washout). Quantitative DCE-MRI pharmacokinetic (PK) parameters included K^trans (influx volume transfer coefficient), K_ep (efflux reflux rate constant) and iAUC (initial area under the curve). DCE-MRI features of true positive lesions were evaluated for overall, index, transition zone (TZ) and peripheral zone (PZ), based on GS grade (low = 6, high > 6) and PI-RADSv2 score using SPSSv24.

Results: There were 57 (17.6%) low-grade and 266 (82.4%) high-grade PCa lesions. PI-RADSv2 3, 4 and 5 included 106, 120 and 97 lesions, respectively. 251 (77.7%) and 72 (22.3%) lesions were located in PZ and TZ, respectively. High-grade lesions had significantly higher proportion of Type 3 curves compared to low-grade lesions in overall (70.3% vs. 54.4%) and TZ (73.5% vs. 43.5%). As PI-RADSv2 increased, the proportion of type 3 curve significantly increased for overall (80.4-51.9%), index (80.4-54.7%) and PZ (78.7-52.1%) lesions. Among PK parameters, K^trans (0.43 vs 0.32) and iAUC (8.99 vs 6.9) for overall PCa, K^trans (0.43 vs 0.31) and iAUC (9 vs 6.67) for PZ PCa, and iAUC (8.94 vs 7.42) for index PCa were significantly higher for high-grade versus low-grade lesions. Also, K^trans (0.51-0.34), K_ep (1.75-1.29) and iAUC (9.79-7.6) for overall PCa, K^trans (0.53-0.32), K_ep (1.81-1.26) and iAUC (9.83-7.34) for PZ PCa; and K_ep (1.79-1.17) and iAUC (11.3-8.45) for index PCa increased significantly with a higher PI-RADSv2 score.

Conclusions: The results of study show the possible utility of qualitative and quantitative DCE-MRI parameters for assessment of PCa GS and PI-RADSv2 categorization.

Keywords: Magnetic resonance imaging; Perfusion imaging; Prostate Imaging and Reporting Data System; Prostate cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Contrast Media
Humans
Magnetic Resonance Imaging*
Male
Neoplasm Grading
Prostatectomy
Prostatic Neoplasms* / diagnostic imaging
Prostatic Neoplasms* / surgery
Retrospective Studies

Substances

Contrast Media

Grants and funding

P50 CA092131/CA/NCI NIH HHS/United States