Purpose of this pilot study was to correlate quantitative parameters derived from the multiparametric magnetic resonance imaging (MP-MRI) of the prostate with results from MRI guided transrectal ultrasound (MRI/TRUS) fusion prostate biopsy in men with suspected prostate cancer.
Thirty-nine consecutive patients who had 3. 0T MP-MRI and subsequent MRI/TRUS fusion prostate biopsy were included and 73 MRI-identified targets were sampled by 177 cores. The pre-biopsy MP-MRI consisted of T2-weighted, diffusion weighted (DWI), and dynamic contrast enhanced (DCE) images. The association of quantitative MRI measurements with biopsy histopathology findings was assessed by Mann-Whitney U- test and Kruskal-Wallis test.
Of 73 targets, biopsy showed benign prostate tissue in 46 (63%), cancer in 23 (31. 5%), and atypia/high grade prostatic intraepithelial neoplasia in four (5. 5%) targets. The median volume of cancer-positive targets was 1. 3 cm3. The cancer-positive targets were located in the peripheral zone (56. 5%), transition zone (39. 1%), and seminal vesicle (4. 3%). Nine of 23 (39. 1%) cancer-positive targets were higher grade cancer (Gleason grade > 6). Higher grade targets and cancer-positive targets compared to benign lesions exhibited lower mean apparent diffusion coefficient (ADC) value (952. 7 < 1167. 9 < 1278. 9), and lower minimal extracellular volume fraction (ECF) (0. 13 < 0. 185 < 0. 213), respectively. The difference in parameters was more pronounced between higher grade cancer and benign lesions.
Our findings from a pilot study indicate that quantitative MRI parameters can predict malignant histology on MRI/TRUS fusion prostate biopsy, which is a valuable technique to ensure adequate sampling of MRI-visible suspicious lesions under TRUS guidance and may impact patient management. The DWI-based quantitative measurement exhibits a stronger association with biopsy findings than the other MRI parameters.
The Canadian journal of urology. 2015 Oct [Epub]
Seyed Saeid Dianat, H Ballentine Carter, Edward M Schaeffer, Ulrik M Hamper, Jonathan I Epstein, Katarzyna J Macura
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.