Premium
Quantitative diffusion‐weighted imaging and dynamic contrast‐enhanced characterization of the index lesion with multiparametric MRI in prostate cancer patients
Author(s) -
Yuan Qing,
Costa Daniel N.,
Sénégas Julien,
Xi Yin,
Wiethoff Andrea J.,
Rofsky Neil M.,
Roehrborn Claus,
Lenkinski Robert E.,
Pedrosa Ivan
Publication year - 2017
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.25391
Subject(s) - prostate cancer , dynamic contrast , diffusion mri , medicine , multiparametric mri , magnetic resonance imaging , dynamic contrast enhanced mri , effective diffusion coefficient , diffusion imaging , radiology , nuclear medicine , cancer
Purpose To compare a simplified intravoxel incoherent motion (sIVIM) model to commonly used monoexponential and biexponential models in the characterization of prostate cancer (PCa) and noncancerous prostate tissues, and to investigate combinations of diffusion‐weighted imaging (DWI) measures with dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI)‐derived parameters in MRI‐visible index lesions, to facilitate PCa risk stratification. Materials and Methods In this retrospective, Institutional Review Board (IRB)‐approved study, 43 consecutive patients with PCa who had 3T MRI exams followed by radical prostatectomy were included. DWI and DCE parameters were measured from one index lesion per patient, and noncancerous central gland and peripheral zone. Logistic regression modeling was performed to select the optimal combination of DWI and DCE measurements for tumor risk assessment. Results All diffusion models showed the lowest diffusion coefficients in tumors, intermediate values in noncancerous central gland, and highest values in noncancerous peripheral zone (all P < 0.001). K trans and k ep were higher in tumors compared to central gland ( P < 0.005) and peripheral zone ( P < 0.001). The initial area under the contrast concentration curve was higher in tumor than the peripheral zone ( P < 0.001). The area under the receiver operating characteristic curve of the combined DWI and DCE parameters (0.78) was higher than its individual components (0.73 and 0.63, respectively) for discriminating low‐ and intermediate‐to‐high‐risk tumors. Conclusion The sIVIM model provided comparable results with fewer b‐values and shorter image acquisition time. The combination of DWI and DCE measurements of MRI‐visible index lesions improved the preoperative prostate cancer risk characterization compared to the individual parameters from either technique alone. Level of Evidence: 3 J. Magn. Reson. Imaging 2017;45:908–916.