nach oben

Erschienen in:

01.08.2012 | Urogenital

Detectability of low and intermediate or high risk prostate cancer with combined T2-weighted and diffusion-weighted MRI

verfasst von: Kyung Won Doo, Deuk Jae Sung, Beom Jin Park, Min Ju Kim, Sung Bum Cho, Yu Whan Oh, Young Hwii Ko, Kyung Sook Yang

Erschienen in: European Radiology | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the incremental value of diffusion-weighted imaging (DWI) in combination with T2-weighted imaging to detect low (Gleason score, ≤ 6) and intermediate or high risk (Gleason score, ≥ 7) prostate cancer.

Methods

Fifty-one patients who underwent MRI before prostatectomy were evaluated. Two readers independently scored the probability of tumour in eight regions of prostate on T2-weighted images (T2WI) and T2WI combined with apparent diffusion coefficient (ADC) maps. Data were divided into two groups—low risk and intermediate or high risk prostate cancer—and correlated with histopathological results. Diagnostic performance parameters, areas under the receiver-operating characteristic curve (AUCs) and interreader agreement were calculated.

Results

For both readers, AUCs of combined T2WI and ADC maps were greater than those of T2WI in intermediate or high risk (reader 1, 0.887 vs. 0.859; reader 2, 0.732 vs 0.662, P < 0.05) prostate cancers, but not in low risk (reader 1, 0.719 vs 0.725; reader 2, 0.685 vs. 0.680, P > 0.05) prostate cancers. Weighted κ value of combined T2WI and ADC maps was 0.689.

Conclusions

The addition of DWI to T2-weighted imaging improves the accuracy of detecting intermediate or high risk prostate cancers, but not for low risk prostate cancer detection.

Key Points

• Gleason scores influence diagnostic performance of MRI for prostate cancer detection.

• Addition of DWI does not improve low risk prostate cancer detection.

• Combined T2WI and DWI may help select intermediate or high risk patients.

Hricak H, Choyke PL, Eberhardt SC, Leibel SA, Scardino PT (2007) Imaging prostate cancer: a multidisciplinary perspective. Radiology 243:28–53PubMedCrossRef

Pickles MD, Gibbs P, Sreenivas M, Turnbull LW (2006) Diffusion-weighted imaging of normal and malignant prostate tissue at 3.0 T. J Magn Reson Imaging 23:130–134PubMedCrossRef

Gibbs P, Pickles MD, Turnbull LW (2006) Diffusion imaging of the prostate at 3.0 Tesla. Invest Radiol 41:185–188PubMedCrossRef

DeSouza NM, Reinsberg SA, Scurr ED, Brewster JM, Payne GS (2007) Magnetic resonance imaging in prostate cancer: the value of apparent diffusion coefficients for identifying malignant nodules. Br J Radiol 80:90–95PubMedCrossRef

Kim CK, Park BK, Han JJ, Kang TW, Lee HM (2007) Diffusion-weighted imaging of the prostate at 3 T for differentiation of malignant and benign tissue in transition and peripheral zones: preliminary results. J Comput Assist Tomogr 31:449–454PubMedCrossRef

Haider MA, van der Kwast TH, Tanguay J et al (2007) Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. AJR Am J Roentgenol 189:323–328PubMedCrossRef

Lim HK, Kim JK, Kim KA, Cho KS (2009) Prostate cancer: apparent diffusion coefficient map with T2-weighted images for detection—a multireader study. Radiology 250:145–151PubMedCrossRef

Katahira K, Takahara T, Kwee TC et al (2011) Ultra-high-b-value diffusion-weighted MR imaging for the detection of prostate cancer: evaluation in 201 cases with histopathological correlation. Eur Radiol 21:188–196PubMedCrossRef

Tan CH, Wang J, Kundra V (2011) Diffusion weighted imaging in prostate cancer. Eur Radiol 21:593–603PubMedCrossRef

10.

Vargas HA, Akin O, Franiel T et al (2011) Diffusion-weighted endorectal MR Imaging at 3 T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 259:775–784PubMedCrossRef

11.

Bostwick DG, Foster CS (1999) Predictive factors in prostate cancer: current concepts from the 1999 college of American pathologists conference on solid tumor prognostic factors and the 1999 World Health Organization second international consultation on prostate cancer. Semin Urol Oncol 17:222–272PubMed

12.

Woodfield CA, Tung GA, Grand DJ, Pezzullo JA, Machan JT, Renzulli JF II (2010) Diffusion-weighted MRI of peripheral zone prostate cancer: comparison of tumor apparent diffusion coefficient with Gleason score and percentage of tumor on core biopsy. AJR Am J Roentgenol 194:W316–322PubMedCrossRef

13.

Tamada T, Sone T, Yoshimasa J et al (2008) Apparent diffusion coefficient values in peripheral and transition zones of the prostate: comparison between normal and malignant prostatic tissue and correlation with histologic grade. J Magn Reson Imaging 28:720–726PubMedCrossRef

14.

Itou Y, Nakanishi K, Narumi Y, Nishizawa Y, Tsukuma H (2011) Clinical utility of apparent diffusion coefficient (ADC) values in patients with prostate cancer: can ADC values contribute to assess the aggressiveness of prostate cancer? J Magn Reson Imaging 33:167–172PubMedCrossRef

15.

Turkbey B, Shah VP, Pang Y et al (2011) Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images? Radiology 258:488–495PubMedCrossRef

16.

Yoshimitsu K, Kiyoshima K, Irie H et al (2008) Usefulness of apparent diffusion coefficient map in diagnosing prostate carcinoma: correlation with stepwise histopathology. J Magn Reson Imaging 27:132–139PubMedCrossRef

17.

Portalez D, Rollin G, Leandri P et al (2010) Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies. Eur Radiol 20:2781–2790PubMedCrossRef

18.

Langer DL, van der Kwast TH, Evans AJ et al (2010) Prostate tissue composition and MR measurements: investigating the relationships between ADC, T2, K(trans), v(e), and corresponding histologic features. Radiology 255:485–494PubMedCrossRef

19.

Rosenkrantz AB, Mannelli L, Kong X et al (2011) Prostate cancer: utility of fusion of T2-weighted and high b-value diffusion-weighted images for peripheral zone tumor detection and localization. J Magn Reson Imaging 34:95–100PubMedCrossRef

20.

Ahmed HU, Kirkham A, Arya M et al (2009) Is it time to consider a role for MRI before prostate biopsy? Nat Rev Clin Oncol 6:197–206PubMedCrossRef

21.

Kozlowski P, Chang SD, Jones EC, Berean KW, Chen H, Goldenberg SL (2006) Combined diffusion-weighted and dynamic contrast-enhanced MRI for prostate cancer diagnosis—correlation with biopsy and histopathology. J Magn Reson Imaging 24:108–113PubMedCrossRef

22.

Hricak H (2005) MR imaging and MR spectroscopic imaging in the pre-treatment evaluation of prostate cancer. Br J Radiol 78:S103–S111PubMedCrossRef

23.

Girouin N, Mège-Lechevallier F, Tonina Senes A et al (2007) Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable? Eur Radiol 17:1498–1509PubMedCrossRef

24.

Zakian KL, Sircar K, Hricak H et al (2005) Correlation of proton MR spectroscopic imaging with Gleason score based on step-section pathologic analysis after radical prostatectomy. Radiology 234:804–814PubMedCrossRef

25.

Klotz L (2005) Active surveillance for prostate cancer: for whom? J Clin Oncol 23:8165–8169PubMedCrossRef

26.

Franiel T, Hamm B, Hricak H (2011) Dynamic contrast-enhanced magnetic resonance imaging and pharmacokinetic models in prostate cancer. Eur Radiol 21:616–626PubMedCrossRef

27.

Oto A, Yang C, Kayhan A et al (2011) Diffusion-weighted and dynamic contrast-enhanced MRI of prostate cancer: correlation of quantitative MR parameters with Gleason score and tumor angiogenesis. AJR Am J Roentgenol 197:1382–1390PubMedCrossRef

28.

van As NJ, de Souza NM, Riches SF et al (2009) A study of diffusion-weighted magnetic resonance imaging in men with untreated localized prostate cancer on active surveillance. Eur Urol 56:981–987PubMedCrossRef

29.

Cohen MS, Hanley RS, Kurteva T et al (2008) Comparing the Gleason prostate biopsy and Gleason prostatectomy grading system: the Lahey clinic medical center experience and an international meta-analysis. Eur Urol 54:371–381PubMedCrossRef

30.

Corcoran NM, Hong MK, Casey RG et al (2011) Upgrade in Gleason score between prostate biopsies and pathology following radical prostatectomy significantly impacts upon the risk of biochemical recurrence. BJU Int 108:E202–210PubMedCrossRef

31.

Bittencourt LK, Barentsz JO, de Miranda LC, Gasparetto EL (2012) Prostate MRI: diffusion-weighted imaging at 1.5 T correlates better with prostatectomy Gleason grades than TRUS-guided biopsies in peripheral zone tumours. Eur Radiol 22:468–475PubMedCrossRef

Titel: Detectability of low and intermediate or high risk prostate cancer with combined T2-weighted and diffusion-weighted MRI
verfasst von: Kyung Won Doo
Deuk Jae Sung
Beom Jin Park
Min Ju Kim
Sung Bum Cho
Yu Whan Oh
Young Hwii Ko
Kyung Sook Yang
Publikationsdatum: 01.08.2012
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 8/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2430-5

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Detectability of low and intermediate or high risk prostate cancer with combined T2-weighted and diffusion-weighted MRI