Washout gradient in dynamic contrast-enhanced MRI is associated with tumor aggressiveness of prostate cancer

Purpose: To investigate the associations between dynamic contrast‐enhanced magnetic resonance imaging (DCE MRI) parameters and the Gleason score (GS) for prostate cancer (PCA) with localization information provided by concurrent apparent diffusion coefficient (ADC) maps. Materials and Methods: Forty...

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Published in:Journal of magnetic resonance imaging 2012-10, Vol.36 (4), p.912-919
Main Authors: Chen, Yu-Jen, Chu, Woei-Chyn, Pu, Yeong-Shiau, Chueh, Shih-Chieh, Shun, Chia-Tung, Tseng, Wen-Yih Isaac
Format: Article
Language:English
Subjects:
Aged
Algorithms
Contrast Media
diffusion tensor imaging (DTI)
dynamic contrast-enhanced MRI (DCE MRI)
Gadolinium DTPA
Gleason score (GS)
Humans
Image Enhancement - methods
Image Interpretation, Computer-Assisted - methods
magnetic resonance imaging (MRI)
Magnetic Resonance Imaging - methods
Male
Middle Aged
Neoplasm Invasiveness
prostate cancer (PCA)
Prostatic Neoplasms - pathology
Reproducibility of Results
Sensitivity and Specificity
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Summary:Purpose: To investigate the associations between dynamic contrast‐enhanced magnetic resonance imaging (DCE MRI) parameters and the Gleason score (GS) for prostate cancer (PCA) with localization information provided by concurrent apparent diffusion coefficient (ADC) maps. Materials and Methods: Forty‐three male patients received MR scans, including diffusion tensor imaging (DTI) and DCE MRI, on a 1.5 T MR system. All patients were confirmed to have PCA in the following biopsy within 2 weeks. ADC maps calculated from DTI were used to colocalize cancerous and noncancerous regions on DCE MRI for perfusion analysis retrospectively. Semiquantitative parameters (peak enhancement, initial gradient, and washout gradient [WG] and quantitative parameters [Ktrans, νe, and kep]) were calculated and correlated with the GS. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the perfusion parameters in assessing the aggressiveness of PCA. Results: A total of 41 PCA nodules were included in the analysis. Among all quantitative and semiquantitative parameters, only WG showed significant correlation with GS (r = −0.75, P < 0.0001). By defining tumor aggressiveness as a GS >6, WG demonstrated a good diagnostic performance, with the area under the ROC curve being 0.88. Under a cutoff point of WG = 0.125 min−1, the sensitivity and specificity were 0.87 and 0.78, respectively. Conclusion: WG shows a significant association with GS and good diagnostic performance in assessing tumor aggressiveness. Therefore, WG is a potential marker of GS. J. Magn. Reson. Imaging 2012;36:912–919. © 2012 Wiley Periodicals, Inc.
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.23723