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Differentiating clinically significant prostate cancer from clinically insignificant prostate cancer using qualitative and semi-quantitative indices of dynamic contrast-enhanced MRI

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Title: Differentiating clinically significant prostate cancer from clinically insignificant prostate cancer using qualitative and semi-quantitative indices of dynamic contrast-enhanced MRI
Authors: Tsutomu Tamada, Mitsuru Takeuchi, Hiroyuki Watanabe, Atsushi Higaki, Kazunori Moriya, Akihiko Kanki, Yoshihiko Fukukura, Akira Yamamoto
Source: Discover Oncology, Vol 15, Iss 1, Pp 1-14 (2024)
Publisher Information: Springer, 2024.
Publication Year: 2024
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Prostate cancer, Tumor aggressiveness, MRI, Dynamic contrast-enhanced MRI, PI-RADS, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Purpose To investigate the utility of qualitative and semi-quantitative evaluation of DCE-MRI for detecting clinically significant prostate cancer (csPC). Methods This retrospective study analyzed 307 lesions in 231 patients who underwent 3.0T MRI. Experienced radiologists assessed PI-RADS v 2.1 assessment category, qualitative contrast enhancement (QCE), contrast enhancement pattern (CEP: type 1, 2, 3), tumor contrast ratio, and tumor size of PC lesions in consensus. Mean and 0–10th-percentile ADC value of the lesion (ADCmean and ADC0−10) were calculated. Specimens obtained from MRI–ultrasound fusion-guided prostate biopsy were used as the pathological reference standard. Results In assessment of tumor aggressiveness, PI-RADS assessment category, QCE, tumor size, and ratio of CEP 2 + 3 were significantly higher in PC with Gleason score (GS) ≥ 3 + 4 (n = 256) than in PC with GS = 6 (n = 51) (P ≤ 0.001). Tumor ADCmean and tumor ADC0−10 were comparable between PC with GS ≥ 3 + 4 and PC with GS = 6 (P = 0.164 to 0.504). Regarding diagnostic performance of csPC in 45 PI-RADS 3 transition zone lesions, only ratio of CEP 2 + 3 was significantly higher in PC with GS ≥ 3 + 4 (n = 31) than in PC with GS = 6 (n = 14) (P = 0.008). Conclusion Qualitative DCE-MRI indices may contribute to PC aggressiveness and improve detection of csPC in PI-RADS assessment category 3 lesions.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2730-6011
Relation: https://doaj.org/toc/2730-6011
DOI: 10.1007/s12672-024-01668-9
Access URL: https://doaj.org/article/4cf5b73da8614ae3ae3d650a8cdbfe68
Accession Number: edsdoj.4cf5b73da8614ae3ae3d650a8cdbfe68
Database: Directory of Open Access Journals
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  Data: Differentiating clinically significant prostate cancer from clinically insignificant prostate cancer using qualitative and semi-quantitative indices of dynamic contrast-enhanced MRI
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  Data: <searchLink fieldCode="AR" term="%22Tsutomu+Tamada%22">Tsutomu Tamada</searchLink><br /><searchLink fieldCode="AR" term="%22Mitsuru+Takeuchi%22">Mitsuru Takeuchi</searchLink><br /><searchLink fieldCode="AR" term="%22Hiroyuki+Watanabe%22">Hiroyuki Watanabe</searchLink><br /><searchLink fieldCode="AR" term="%22Atsushi+Higaki%22">Atsushi Higaki</searchLink><br /><searchLink fieldCode="AR" term="%22Kazunori+Moriya%22">Kazunori Moriya</searchLink><br /><searchLink fieldCode="AR" term="%22Akihiko+Kanki%22">Akihiko Kanki</searchLink><br /><searchLink fieldCode="AR" term="%22Yoshihiko+Fukukura%22">Yoshihiko Fukukura</searchLink><br /><searchLink fieldCode="AR" term="%22Akira+Yamamoto%22">Akira Yamamoto</searchLink>
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  Data: Discover Oncology, Vol 15, Iss 1, Pp 1-14 (2024)
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  Data: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
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  Data: <searchLink fieldCode="DE" term="%22Prostate+cancer%22">Prostate cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Tumor+aggressiveness%22">Tumor aggressiveness</searchLink><br /><searchLink fieldCode="DE" term="%22MRI%22">MRI</searchLink><br /><searchLink fieldCode="DE" term="%22Dynamic+contrast-enhanced+MRI%22">Dynamic contrast-enhanced MRI</searchLink><br /><searchLink fieldCode="DE" term="%22PI-RADS%22">PI-RADS</searchLink><br /><searchLink fieldCode="DE" term="%22Neoplasms%2E+Tumors%2E+Oncology%2E+Including+cancer+and+carcinogens%22">Neoplasms. Tumors. Oncology. Including cancer and carcinogens</searchLink><br /><searchLink fieldCode="DE" term="%22RC254-282%22">RC254-282</searchLink>
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  Data: Abstract Purpose To investigate the utility of qualitative and semi-quantitative evaluation of DCE-MRI for detecting clinically significant prostate cancer (csPC). Methods This retrospective study analyzed 307 lesions in 231 patients who underwent 3.0T MRI. Experienced radiologists assessed PI-RADS v 2.1 assessment category, qualitative contrast enhancement (QCE), contrast enhancement pattern (CEP: type 1, 2, 3), tumor contrast ratio, and tumor size of PC lesions in consensus. Mean and 0–10th-percentile ADC value of the lesion (ADCmean and ADC0−10) were calculated. Specimens obtained from MRI–ultrasound fusion-guided prostate biopsy were used as the pathological reference standard. Results In assessment of tumor aggressiveness, PI-RADS assessment category, QCE, tumor size, and ratio of CEP 2 + 3 were significantly higher in PC with Gleason score (GS) ≥ 3 + 4 (n = 256) than in PC with GS = 6 (n = 51) (P ≤ 0.001). Tumor ADCmean and tumor ADC0−10 were comparable between PC with GS ≥ 3 + 4 and PC with GS = 6 (P = 0.164 to 0.504). Regarding diagnostic performance of csPC in 45 PI-RADS 3 transition zone lesions, only ratio of CEP 2 + 3 was significantly higher in PC with GS ≥ 3 + 4 (n = 31) than in PC with GS = 6 (n = 14) (P = 0.008). Conclusion Qualitative DCE-MRI indices may contribute to PC aggressiveness and improve detection of csPC in PI-RADS assessment category 3 lesions.
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