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Erschienen in: Abdominal Radiology 6/2019

06.04.2019 | Pelvis

Revisiting quantitative multi-parametric MRI of benign prostatic hyperplasia and its differentiation from transition zone cancer

verfasst von: Aritrick Chatterjee, Alexander J. Gallan, Dianning He, Xiaobing Fan, Devkumar Mustafi, Ambereen Yousuf, Tatjana Antic, Gregory S. Karczmar, Aytekin Oto

Erschienen in: Abdominal Radiology | Ausgabe 6/2019

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Abstract

Purpose

This study investigates the multiparametric MRI (mpMRI) appearance of different types of benign prostatic hyperplasia (BPH) and whether quantitative mpMRI is effective in differentiating between prostate cancer (PCa) and BPH.

Materials and methods

Patients (n = 60) with confirmed PCa underwent preoperative 3T MRI. T2-weighted, multi-echo T2-weighted, diffusion weighted and dynamic contrast enhanced images (DCE) were obtained prior to undergoing prostatectomy. PCa and BPH (cystic, glandular or stromal) were identified in the transition zone and matched with MRI. Quantitative mpMRI metrics: T2, ADC and DCE-MRI parameters using an empirical mathematical model were measured.

Results

ADC values were significantly lower (p < 0.001) in PCa compared to all BPH types and can differentiate between PCa and BPH with high accuracy (AUC = 0.87, p < 0.001). T2 values were significantly lower (p < 0.001) in PCa compared to cystic BPH only, while glandular (p = 0.27) and stromal BPH (p = 0.99) showed no significant difference from PCa. BPH mimics PCa in the transition zone on DCE-MRI evidenced by no significant difference between them. mpMRI values of glandular (ADC = 1.31 ± 0.22 µm2/ms, T2 = 115.7 ± 37.3 ms) and cystic BPH (ADC = 1.92 ± 0.43 µm2/ms, T2 = 242.8 ± 117.9 ms) are significantly different. There was no significant difference in ADC (p = 0.72) and T2 (p = 0.46) between glandular and stromal BPH.

Conclusions

Multiparametric MRI and specifically quantitative ADC values can be used for differentiating PCa and BPH, improving PCa diagnosis in the transition zone. However, DCE-MRI metrics are not effective in distinguishing PCa and BPH. Glandular BPH are not hyperintense on ADC and T2 as previously thought and have similar quantitative mpMRI measurements to stromal BPH. Glandular and cystic BPH appear differently on mpMRI and are histologically different.
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Metadaten
Titel
Revisiting quantitative multi-parametric MRI of benign prostatic hyperplasia and its differentiation from transition zone cancer
verfasst von
Aritrick Chatterjee
Alexander J. Gallan
Dianning He
Xiaobing Fan
Devkumar Mustafi
Ambereen Yousuf
Tatjana Antic
Gregory S. Karczmar
Aytekin Oto
Publikationsdatum
06.04.2019
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 6/2019
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-019-01936-1

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