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Multi‐parametric (mp) MRI of prostatic ductal adenocarcinoma
Author(s) -
Coffey Niamh,
Schieda Nicola,
Cron Greg,
Gulavita Previn,
Mai Kien T,
Flood Trevor A.
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24694
Subject(s) - medicine , effective diffusion coefficient , prostatectomy , prostate cancer , prostatic adenocarcinoma , prostate , urology , adenocarcinoma , nuclear medicine , magnetic resonance imaging , univariate analysis , cancer , radiology , multivariate analysis
Background Prostatic ductal adenocarcinoma (DCa) is an aggressive variant of conventional adenocarcinoma (CCa) with mixed DCa and CCa tumors comprising up to 5% of all prostate cancers. DCa may be underestimated on T2‐weighted (T2W) MRI. This study assessed the mp‐MRI appearance of DCa as compared with CCa. Methods With research ethics board approval, we identified 38 patients who underwent mp‐MRI (T2W, DWI, and DCE) and radical prostatectomy (RP) between 2012 and 2014. Eight DCa in 8 patients and 39 CCa tumor foci in 30 consecutive patients were identified. Tumor volume, apparent diffusion coefficient (ADC;10 −3 mm 2 /s), and time‐signal intensity (SI) curves were calculated. Parametric data were compared using the Kruskal‐Wallis test and univariate regression. Time‐SI curves were compared using the chi‐square test. Results Tumor volumes were: 1.62(±1.02) for DCa, 1.03(±0.54) for Gleason 9, 0.88(±0.93) for Gleason 7/8, and 0.26(±0.14) mL for Gleason 6. There was no difference in size between DCa and Gleason 9 ( P = 0.22); however, DCa were larger than Gleason 7/8 ( P = 0.03) and Gleason 6 ( P = 0.003) tumors. ADC values were: 0.789(±0.22) for DCa, 1.01(±0.19) for Gleason 9, 0.992(±0.23) for Gleason 7/8 and 1.389(±0.41) 10 −3 mm 2 /s for Gleason 6 tumors. There was no difference in ADC between DCa and Gleason 9 ( P = 0.14) or Gleason 7/8 ( P = 0.055) tumors. There was a difference in ADC for DCa and Gleason ≥7 CCa compared to Gleason 6 tumors, ( P < 0.001 and P = 0.012). All DCa demonstrated type III time‐SI curves. Gleason ≥ 7 tumors demonstrated type II/III curves. Gleason 6 tumors demonstrated Type I/II time‐SI curves. There was no difference in curve type between groups, ( P = 0.18). Conclusion Although DCa mimics Gleason score 3 + 3 = 6 tumor at T2W MRI; DCa resembles Gleason ≥7 CCa on mp‐MRI. J. Magn. Reson. Imaging 2015;41:1639–1645 . © 2014 Wiley Periodicals, Inc .