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Dynamic contrast‐enhanced MRI of the prostate: An intraindividual assessment of the effect of temporal resolution on qualitative detection and quantitative analysis of histopathologically proven prostate cancer
Author(s) -
Ream Justin M.,
Doshi Ankur M.,
Dunst Diane,
Parikh Nainesh,
Kong Max X.,
Babb James S.,
Taneja Samir S.,
Rosenkrantz Andrew B.
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.25451
Subject(s) - prostate cancer , medicine , receiver operating characteristic , prostatectomy , magnetic resonance imaging , prostate , nuclear medicine , contrast (vision) , urology , radiology , cancer , artificial intelligence , computer science
Purpose To assess the effects of temporal resolution (R T ) in dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) on qualitative tumor detection and quantitative pharmacokinetic parameters in prostate cancer. Materials and Methods This retrospective Institutional Review Board (IRB)‐approved study included 58 men (64 ± 7 years). They underwent 3T prostate MRI showing dominant peripheral zone (PZ) tumors (24 with Gleason ≥ 4 + 3), prior to prostatectomy. Continuously acquired DCE utilizing GRASP (Golden‐angle RAdial Sparse Parallel) was retrospectively reconstructed at R T of 1.4 sec, 3.7 sec, 6.0 sec, 9.7 sec, and 14.9 sec. A reader placed volumes‐of‐interest on dominant tumors and benign PZ, generating quantitative pharmacokinetic parameters (k trans , v e ) at each R T . Two blinded readers assessed each R T for lesion presence, location, conspicuity, and reader confidence on a 5‐point scale. Data were assessed by mixed‐model analysis of variance (ANOVA), generalized estimating equation (GEE), and receiver operating characteristic (ROC) analysis. Results R T did not affect sensitivity (R1 all : 69.0%–72.4%, all P adj = 1.000; R1 GS≥4 + 3 : 83.3–91.7%, all P adj = 1.000; R2 all : 60.3–69.0%, all P adj = 1.000; R2 GS≥4 + 3 : 58.3%–79.2%, all P adj = 1.000). R1 reported greater conspicuity of GS ≥ 4 + 3 tumors at R T of 1.4 sec vs. 14.9 sec (4.29 ± 1.23 vs. 3.46 ± 1.44; P adj = 0.029). No other tumor conspicuity pairwise comparison reached significance (R1 all : 2.98–3.43, all P adj ≥ 0.205; R2 all : 2.57–3.19, all P adj ≥ 0.059; R1 GS≥4 + 3 : 3.46–4.29, all other P adj ≥ 0.156; R2 GS≥4 + 3 : 2.92–3.71, all P adj ≥ 0.439). There was no effect of R T on reader confidence (R1 all : 3.17–3.34, all P adj = 1.000; R2 all : 2.83–3.19, all P adj ≥ 0.801; R1 GS≥4 + 3 : 3.79–4.21, all P adj = 1.000; R2 GS≥4 + 3 : 3.13–3.79, all P adj = 1.000). k trans and v e of tumor and benign tissue did not differ across R T (all adjusted P values [ P adj ] = 1.000). R T did not significantly affect area under the curve (AUC) of K trans or v e for differentiating tumor from benign (all P adj = 1.000). Conclusion Current PI‐RADS recommendations for R T of 10 seconds may be sufficient, with further reduction to the stated PI‐RADS preference of R T ≤ 7 seconds offering no benefit in tumor detection or quantitative analysis. Level of Evidence : 3 J. MAGN. RESON. IMAGING 2017;45:1464–1475